目的 探討痰熱清注射液聯(lián)合注射用頭孢哌酮鈉舒巴坦鈉治療重癥肺炎的臨床療效。方法 選取2019年6月—2021年6月鄭州大學第五附屬醫(yī)院收治的87例重癥肺炎患者，按照隨機數(shù)字表法將所有患者分為對照組（43例）和治療組（44例）。對照組靜脈滴注注射用頭孢哌酮舒巴坦鈉，3.0 g/次，2次/d。治療組在對照組基礎上靜脈滴注痰熱清注射液，20 mL加入500 mL葡萄糖注射液中，1次/d。兩組患者連續(xù)治療14 d。觀察兩組的治療效果，比較兩組患者主要癥狀的消失時間、肺部感染程度和血清炎癥因子水平。結果 治療后，治療組患者的總有效率（95.45%）高于對照組的總有效率（81.40%）（P<0.05）。治療后，治療組發(fā)熱、咳嗽、肺啰音、肺部陰影消失時間均短于對照組（P<0.05）。治療后，兩組的臨床肺部感染評分（CPIS）顯著降低（P<0.05），且治療組CPIS明顯低于對照組（P<0.05）。治療后，兩組的中性粒細胞與淋巴細胞比值（NLR）、白細胞介素-6（IL-6）、白細胞介素-8（IL-8）水平顯著降低（P<0.05），且治療組NLR、IL-6、IL-8水平比對照組降低更明顯（P<0.05）。結論 痰熱清注射液聯(lián)合注射用頭孢哌酮鈉舒巴坦鈉可提高重癥肺炎的臨床療效，能加快主要癥狀改善，減輕肺感染程度和炎癥反應，藥物安全性良好。

Objective To investigate the clinical efficacy of Tanreqing Injection combined with Cefoperazone Sodium and Sulbactam Sodium for injection in treatment of severe pneumonia. Methods Patients (87 cases) with severe pneumonia in the Fifth Affiliated Hospital of Zhengzhou University from June 2019 to June 2021 were randomly divided into the control group (43 cases) and the treatment group (44 cases). Patients in the control group were iv administered with Cefoperazone Sodium and Sulbactam Sodium for injection, 3.0 g/time, twice daily. Patients in the treatment group were iv administered with Tanreqing Injection on the basis of the control group, 20 mL added into glucose solution 500 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and disappearance times of main symptoms, degree of pulmonary infection, and serum inflammatory factor levels in two groups were compared. Results After treatment, the total effective rate of the treatment group (95.45%) was higher than that of the control group (81.40%) (P<0.05). After treatment, the disappearance times of fever, cough, pulmonary rale, and pulmonary shadow in the treatment group was shorter than that in the control group (P<0.05). After treatment, the CPIS scores of two groups were significantly decreased (P<0.05), and the CPIS scores of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, the levels of NLR, IL-6, and IL-8 in two groups were significantly decreased (P<0.05), and the levels of NLR, IL-6, and IL-8 in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Tanreqing Injection combined with cefoperazone and slbactam can improve the curative effect of severe pneumonia, accelerate the improvemen of symptom t, and reduce the degree of pulmonary infection and inflammatory reaction, with good safety.

R974

河南省醫(yī)學科技攻關計劃項目（2018020243）