目的 研究血必凈注射液聯(lián)合重組人血小板生成素注射液治療膿毒癥相關(guān)性血小板減少癥的臨床療效。方法 選取2017年12月-2019年12月在天津市中醫(yī)藥研究院附屬醫(yī)院治療的70例膿毒癥相關(guān)性血小板減少癥患者，將所有患者隨機(jī)分為對(duì)照組和治療組，每組各35例。對(duì)照組靜脈滴注重組人血小板生成素注射液，300 U/kg，1次/d，患者在用藥過程中待血小板絕對(duì)值升高≥ 50×10⁹/L或血小板>100×10⁹/L即應(yīng)停用。治療組在對(duì)照組基礎(chǔ)上靜脈滴注血必凈注射液，50 mL/次，2次/d。兩組患者均持續(xù)治療14 d。觀察兩組臨床療效，比較兩組血小板水平動(dòng)態(tài)變化、血清Toll4受體（TLR4）、血小板第4因子（PF4）和內(nèi)源性血小板生成素（TPO）水平及血清血管性血友病因子（vWF）、腫瘤壞死因子-α（TNF-α）、可溶性CD40配體（sCD40L）水平。結(jié)果 治療后，治療組總有效率為94.29%，對(duì)照組總有效率為82.86%，治療組總有效率顯著高于對(duì)照組（P<0.05）。治療3、5、7、10 d后，治療組血小板水平均高于同期對(duì)照組（P<0.05）。治療后，兩組患者血清TLR4、PF4和TPO水平明顯降低（P<0.05）；且治療組血清TLR4、PF4和TPO水平降低較明顯（P<0.05）。治療后，兩組血清vWF、TNF-α和sCD40L水平均顯著降低（P<0.05）；并且治療組患者血清vWF、TNF-α和sCD40L水平降低較明顯（P<0.05）。結(jié)論 血必凈注射液聯(lián)合重組人血小板生成素注射液治療膿毒癥相關(guān)性血小板減少癥具有較好的治療效果，可降低血清TLR4、PF4、TPO水平和vWF、TNF-α和sCD40L水平。

Objective To study the efficacy of Xubijing Injection combined with Recombinant Human Thrombopoietin Injection in treatment of sepsis associated thrombocytopenia. Methods Patients (70 cases) with sepsis associated thrombocytopenia in the Affiliated Hospital of Tianjin Institute of Chinese Medicine from December 2017 to December 2019 were randomly divided into control and treatment groups, and each group had 35 cases. Patients in the control group were iv administered with Recombinant Human Thrombopoietin Injection, 300 U/kg, once daily, and patients should stop using the drug when the absolute value of platelets increased ≥ 50×10⁹/L, or platelets > 100×10⁹/L. Patients in the treatment group were iv administered with Xubijing Injection on the basis of the control group, 50 mL/time, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and the dynamic changes of platelet levels, the serum factors levels of TLR4, PF4, TPO, vWF, TNF-α, and sCD40L in two groups were compared. Results After treatment, the total effective rate of the treatment group was 94.29%, and that of the control group was 82.86%, and the total effective rate of the treatment group was significantly higher than that of the control group (P < 0.05). After treatment for 3, 5, 7, and 10 d, the platelet levels in the treatment group were higher than those in the control group at the same period (P < 0.05). After treatment, the serum levels of TLR4, PF4, and TPO in two groups were significantly decreased (P < 0.05), and the serum levels of TLR4, PF4, and TPO in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of vWF, TNF-α, and sCD40L in two groups were significantly decreased (P < 0.05), and the serum levels of vWF, TNF-α, and sCD40L in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Xubijing Injection combined with Recombinant Human Thrombopoietin Injection has clinical curative effect in treatment of sepsis associated thrombocytopenia, can reduce the serum levels of TLR4, PF4, TPO, vWF, TNF-α, and sCD40L in serum.

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