目的 探討參附注射液聯(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4月-2022年12月重慶市江北區(qū)中醫(yī)院收治的120例重癥肺炎患者，根據(jù)隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各60例。對(duì)照組靜脈滴注注射用頭孢哌酮鈉舒巴坦鈉，3支加入100 mL生理鹽水充分稀釋后滴注，1次/12 h。治療組在對(duì)照組基礎(chǔ)上靜脈滴注參附注射液，50 mL/次，然后以20 mL/h持續(xù)泵注50 mL，1次/12 h。兩組患者連續(xù)治療14 d。觀察兩組的臨床療效，比較兩組患者的高熱、咳嗽、氣喘、肺部陰影消失時(shí)間，以及血氧分壓、氧合指數(shù)、血氧飽和度、D-二聚體、纖維蛋白原、中性粒細(xì)胞-淋巴細(xì)胞比值（NLR）。結(jié)果 治療后，治療組患者總有效率95.00%高于對(duì)照的總有效率83.33%，組間比較差異顯著（P<0.05）。治療后，治療組患者高熱、咳嗽、氣喘、肺部陰影消失時(shí)間均短于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的血氧分壓、氧合指數(shù)、血氧飽和度高于治療前（P<0.05），治療組的血氧分壓、氧合指數(shù)、血氧飽和度高于對(duì)照組（P<0.05）。治療后，兩組的血清D-二聚體、纖維蛋白原、NLR低于治療前（P<0.05），且治療組的D-二聚體、纖維蛋白原、NLR明顯低于對(duì)照組（P<0.05）。結(jié)論 參附注射液聯(lián)合注射用頭孢哌酮鈉舒巴坦鈉治療重癥肺炎的療效確切，能改善臨床癥狀和肺通氣功能，降低炎癥反應(yīng)和血液高凝狀態(tài)。

Objective To investigate the clinical effect of Shenfu Injection combined with Cefoperazone Sodium and Sulbactam Sodium for injection in treatment of severe pneumonia. Methods Patients (120 cases) with severe pneumonia in Chongqing Jiangbei District Hospital of Traditional Chinese Medicine from April 2019 to December 2022 were divided into control and treatment groups according to the random number table method, and each group had 60 cases. Patients in the control group were iv administered with Cefoperazone Sodium and Sulbactam Sodium for injection, 3 bottles added into normal saline 100 mL, once every 12 h. Patients in the treatment group were iv administered with Shenfu Injection on the basis of the control group, 50 mL/time, then continuously pump 50 mL at 20 mL/h, once every 12 h. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and the disappearance times of high temperature, cough, asthma and lung shadow, the blood oxygen partial pressure, oxygenation index, blood oxygen saturation, D-dimer, fibrinogen and NLR in two groups were compared. Results After treatment, the total effective rate (95.00%) in the treatment group was higher than that (83.33%) in the control group, with a significant difference between two groups (P< 0.05). After treatment, the disappearance times of high temperature, cough, asthma, and lung shadows in the treatment group was shorter than that in the control group, and the difference was statistically significant (P < 0.05). After treatment, the blood oxygen partial pressure, oxygenation index, and blood oxygen saturation of two groups were higher than those before treatment (P < 0.05), and the blood oxygen partial pressure, oxygenation index, and blood oxygen saturation of the treatment group were higher than those of the control group (P < 0.05). After treatment, D-dimer, fibrinogen, and NLR of two groups were lower than those before treatment (P < 0.05), and the D-dimer, fibrinogen, and NLR of the treatment group were lower than those of the control group (P < 0.05). Conclusion Shenfu Injection combined with Cefoperazone Sodium and Sulbactam Sodium for injection has definite efficacy in treatment of severe pneumonia, which can improve clinical symptoms and lung ventilation function, reduce inflammatory reactions and blood hypercoagulability.

R974

重慶市衛(wèi)生計(jì)生委醫(yī)學(xué)科研計(jì)劃項(xiàng)目（2015ZBXM042）