目的 探討復(fù)方鮮竹瀝液聯(lián)合哌拉西林鈉舒巴坦鈉治療社區(qū)獲得性肺炎的臨床療效。方法 選取2021年1月—2024年1月首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院收治的102例社區(qū)獲得性肺炎患者，按隨機(jī)數(shù)字表法將患者分為對(duì)照組和治療組，每組各51例。對(duì)照組靜脈滴注注射用哌拉西林鈉他唑巴坦鈉，以0.9%氯化鈉溶液將4.5 g本品溶解后，再加入同一溶媒稀釋至100 mL，緩慢滴注30 min以上，3次/d。治療組在對(duì)照組治療基礎(chǔ)上口服復(fù)方鮮竹瀝液，20 mL/次，3次/d。兩組療程都為10 d。觀察兩組臨床療效和臨床表現(xiàn)消失時(shí)間，比較治療前后相關(guān)量表[社區(qū)獲得性肺炎嚴(yán)重程度（CURB-65）評(píng)分、肺炎胸片吸收評(píng)價(jià)量表（PCRAES）評(píng)分、肺炎嚴(yán)重指數(shù)（PSI）評(píng)分]、氧合指數(shù)（OI）和呼吸頻率（RR）及紅細(xì)胞分布寬度（RDW）、白細(xì)胞介素（IL）-8、IL-17等炎癥指標(biāo)水平。結(jié)果 治療后，治療組總有效率是96.08%，顯著高于對(duì)照組的84.31%（P＜0.05）。治療后，治療組咳嗽、咳痰、胸悶痛、發(fā)熱、肺部啰音的消失時(shí)間都短于對(duì)照組（P＜0.05）。治療后，兩組CURB-65、PCRAES和PSI評(píng)分都顯著降低（P＜0.05）；治療后，治療組CURB-65、PCRAES和PSI評(píng)分低于對(duì)照組（P＜0.05）。治療后，兩組OI顯著升高，而RR都顯著降低（P＜0.05）；治療后，治療組OI高于對(duì)照組，而RR低于對(duì)照組（P＜0.05）。治療后，兩組NLR、RDW和血清CRP、IL-8、IL-17水平都低于治療前（P＜0.05）；治療后，治療組NLR、RDW、CRP、IL-8、IL-17水平都低于對(duì)照組（P＜0.05）。結(jié)論 在哌拉西林鈉舒巴坦鈉治療社區(qū)獲得性肺炎基礎(chǔ)上加用復(fù)方鮮竹瀝液，能有效加快患者臨床表現(xiàn)消除，促進(jìn)肺部感染和病情嚴(yán)重程度的減輕，改善呼吸功能，進(jìn)一步控制機(jī)體炎癥狀態(tài)。

Objective To explore the clinical efficacy of Compound Xianzhuli Liquids combined with piperacillin sodium and sulbactam sodium in treatment of community-acquired pneumonia. Methods A total of 102 patients with community-acquired pneumonia admitted to Beijing Tongren Hospital, Capital Medical University from January 2021 to January 2024 were selected and divided into control group and treatment group according to random number table method, with 51 cases in each group. Patients in control group were iv administered with Piperacillin Sodium and Sulbactam Sodium for injection, dissolved 4.5g of this product with 0.9% Nacl solution, then added the same solvent to dilute to 100 mL, slowly infused for more than 30 min, 3 times daily. Patients in treatment group were po administered with Compound Xianzhuli Liquids on the basis of the control group, 20 mL/time, three times daily. Both groups were treated for 10 d. The clinical efficacy and disappearance time of clinical manifestations of two groups were observed. The relevant scales (CURB-65 score, PCRAES score, PSI score), oxygenation index (OI), respiratory rate (RR), red blood cell distribution width (RDW), IL-8, IL-17 were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 96.08%, which was significantly higher than that of the control group (84.31%, P < 0.05). After treatment, the disappearance time of cough, expectoration, chest pain, fever and lung rales in treatment group was shorter than those in control group (P< 0.05). After treatment, the CURB-65, PCRAES and PSI scores in both groups were significantly decreased (P < 0.05). After treatment, the CURB-65, PCRAES, and PSI scores in treatment group were lower than those in control group (P < 0.05). After treatment, OI was significantly increased, but RR was significantly decreased in both groups (P < 0.05). After treatment, OI in treatment group was higher than that in control group, but RR was lower than that in control group (P < 0.05). After treatment, the levels of NLR, RDW and serum CRP, IL-8, and IL-17 in both groups were lower than those before treatment (P < 0.05). After treatment, the levels of NLR, RDW, CRP, IL-8, and IL-17 in treatment group were lower than those in control group (P < 0.05). Conclusion On the basis of piperacillin sodium and sulbactam sodium in treatment of community-acquired pneumonia, the addition of Compound Xianzhuli Liquids can effectively accelerate the elimination of clinical manifestations of patients, and can promote the reduction of lung infection and disease severity, improve respiratory function, which further control the inflammatory state of the body.

R974