目的 探討血必凈注射液聯(lián)合地塞米松磷酸鈉注射液治療重癥膿毒癥的臨床療效。方法 選取2023年1～12月重慶大學(xué)附屬涪陵醫(yī)院收治的66例重癥膿毒癥患者臨床資料，根據(jù)用藥方案不同分為對(duì)照組和治療組，各33例。對(duì)照組靜脈滴注地塞米松磷酸鈉注射液，10 mg地塞米松注射液與250 mL 5%葡萄糖混合，1次/d。治療組在對(duì)照組基礎(chǔ)上靜脈滴注血必凈注射液，100 mL血必凈注射液與250 mL 5%葡萄糖混合，2次/d。兩組共治療1周。比較兩組臨床療效、臨床癥狀改善時(shí)間、疾病嚴(yán)重程度、血清炎癥因子。結(jié)果 治療后，治療組的總有效率為90.91%，高于對(duì)照組總有效率63.64%（P＜0.05）。治療后，治療組完成復(fù)蘇時(shí)間、血壓復(fù)常時(shí)間、體溫恢復(fù)時(shí)間均短于對(duì)照組（P＜0.05）。治療后，兩組急性生理學(xué)與慢性健康狀況評(píng)價(jià)系統(tǒng)Ⅱ（APACHE bⅡ）評(píng)分均低于治療前（P＜0.05），且治療組患者的APACHEⅡ評(píng)分低于對(duì)照組（P＜0.05）。治療后，兩組血清白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）、C反應(yīng)蛋白（CRP）水平均低于治療前（P＜0.05），且治療組血清CRP、IL-6、TNF-α水平低于對(duì)照組（P＜0.05）。結(jié)論 重癥膿毒癥采用血必凈注射液聯(lián)合地塞米松磷酸鈉注射液治療的療效顯著，可縮短患者臨床癥狀改善時(shí)間，降低患者病情嚴(yán)重程度和炎癥水平。

Objective To explore the therapeutic effect of Xuebijing Injection combined with Dexamethasone Sodium Phosphate Injection in treatment of severe sepsis. Methods Patients (66 cases) with severe sepsis in Chongqing University Fuling Hospital from January to December 2023 were divided into control and treatment groups according to different medication plans, and each group had 33 cases. Patients in the control group were iv administered with Dexamethasone Sodium Phosphate Injection, 10 mg added into 5% glucose solution 250 mL, once daily. Patients in the treatment group were iv administered with Xuebijing Injection on the basis of the control group, 100 mL added into 5% glucose solution 250 mL, twice daily. Patients in two groups were treated for 1 week. The clinical efficacies, clinical symptom improvement time, disease severity, and inflammatory factors serum levels in two groups were compared. Results After treatment, the total effective rate of the treatment group was 90.91%, which was higher than 63.64% of the control group (P < 0.05). After treatment, the recovery time, blood pressure normalization time, and body temperature recovery time of the treatment group were shorter than those of the control group (P < 0.05). After treatment, APACHE II scores of two groups were lower than those before treatment (P < 0.05), and APACHE II scores of the treatment group were lower than those of the control group (P< 0.05). After treatment, the serum levels of CRP, IL-6, and TNF-α in two groups were decreased (P< 0.05), and the serum levels of CRP, IL-6, and TNF-α in treatment group were lower than those in control group (P < 0.05). Conclusion Xuebijing Injection combined with Dexamethasone Sodium Phosphate Injection in treatment of severe sepsis has a significant therapeutic effect, can shorten the time for clinical symptom improvement, reduce the severity of patients’ disease and the level of inflammation.

R977

重慶市自然科學(xué)基金資助項(xiàng)目（cstc2021jcyj-msxmX0628）；重慶市衛(wèi)計(jì)委中醫(yī)藥科研項(xiàng)目（2023WSJK139）