Objective  To observe the clinical effect of bronchoalveolar lavage with ambroxol combined with Shenqi Fuzheng Injection in treatment of severe bronchopneumonitis in children.

  Methods  Clinical data of 205 children with severe bronchopneumonia was analyzed. The children were divided into viral group, bacterial group, mixed group and other pathogen group according to different pathogens. The levels of inflammatory factors, treatment and clinical efficacy of the four groups were compared. The correlation between the levels of interleukin-23 (IL-23) and tumor necrosis factor-α (TNF-α) in bronchoalveolar lavage fluid was analyzed.

  Results  The duration of pediatric intensive care unit (PICU), hospital stay and antibiotic use in the bacterial group and the mixed group were longer than those in the viral group and the other pathogen groups, and the expression levels of IL-23 and TNF-α were higher than those in the viral group and the other pathogen group (P < 0.05). There was a significant positive correlation between IL-23 and TNF-α levels in bronchoalveolar lavage fluid (r=0.978, P < 0.001). After 7 days of treatment, arterial partial pressure of carbon dioxide was lower than before treatment, oxygenation index was higher than before treatment, and the proportions of fever and cough were lower than before treatment (P < 0.05). The effective rates of the viral group and the bacterial group were higher than those in the mixed group and the other pathogen group (P < 0.05).

  Conclusion  Bronchoscopic alveolar lavage with ambroxol and Shenqi Fuzheng Injection can effectively improve the clinical symptoms of children with severe bronchopneumonia, and help to identify the pathogen of bronchopneumonia.