目的 探討痰熱清注射液聯(lián)合注射用西維來司他鈉治療急性呼吸窘迫綜合征的療效。方法 選擇2022年12月—2024年12月在青島市第八人民醫(yī)院就診的86例急性呼吸窘迫綜合征患者，所有患者按隨機數(shù)字表法分為對照組和治療組，每組43例。對照組靜脈滴注注射用西維來司他鈉，每日4.8 mg/kg，加入250 mL生理鹽水24 h持續(xù)靜脈給藥。治療組在對照組基礎上靜脈滴注痰熱清注射液，1次/d，每次20 mL加入500 mL葡萄糖注射液充分稀釋后滴注。兩組持續(xù)治療7 d。比較兩組的臨床療效、病情嚴重程度、血氣指標、血清炎癥指標。結(jié)果 對照組、治療組的總有效率分別為74.42%、90.70%，組間比較差異具有統(tǒng)計學意義（P＜0.05）。兩組治療后急性生理和慢性健康評估（APACHE）Ⅱ評分均顯著降低（P＜0.05），且治療組治療后的APACHE Ⅱ評分低于對照組（P＜0.05）。兩組患者治療后的氧合指數(shù)、肺動態(tài)順應性、氣道峰值顯著升高（P＜0.05），治療組治療后的氧合指數(shù)、肺動態(tài)順應性、氣道峰值高于對照組（P＜0.05）。兩組治療后的血清CD5抗原樣蛋白（CD5L）、可溶性基質(zhì)裂解素2（sST2）、激活素A（Activin-A）水平均降低（P＜0.05），治療組治療后的血清CD5L、sST2、Activin-A水平低于對照組（P＜0.05）。結(jié)論 痰熱清注射液聯(lián)合注射用西維來司他鈉可提高急性呼吸窘迫綜合征的臨床療效，減輕病情嚴重程度，改善血氣指標，減輕炎癥反應。

Objective To explore the clinical efficacy of Tanreqing Injection combined with Sivelestat Sodium for injection in treatment of acute respiratory distress syndrome. Methods A total of 86 patients with acute respiratory distress syndrome who were treated at Qingdao Eighth People’s Hospital from December 2022 to December 2024 were selected. All patients were randomly divided into control group and treatment group using a random number table method, with 43 cases in each group. Patients in the control group received intravenous infusion of Sivelestat Sodium for injection, with a daily dose of 4.8 mg/kg, and 250 mL of physiological saline was added for 24 h of continuous intravenous administration. Patients in the treatment group were intravenously infused with Tanreqing Injection on the basis of the control group, once daily, with 20 mL added each time and 500 mL glucose injection diluted thoroughly before infusion. Two groups of patients were treated continuously for 7 d. The clinical efficacy, severity of the condition, blood gas indicators, and serum inflammation indicators were compared between two groups. Results The total effective rates of the control group and the treatment group were 74.42% and 90.70%, respectively, and the difference was statistically significant between two groups (P < 0.05). After treatment, APACHE II scores in two groups significantly decreased (P < 0.05), and the APACHE II scores in the treatment group was lower than those in the control group (P < 0.05). After treatment, the oxygenation index, lung dynamic compliance, and peak airway value significantly increased in two groups (P < 0.05), and the oxygenation index, lung dynamic compliance, and peak airway value in the treatment group were higher than those in the control group (P < 0.05). After treatment, the serum levels of CD5L, sST2, and Activin-A in both groups were decreased (P < 0.05). The levels of serum CD5L, sST2, and Activin-A in the treatment group were lower than those in the control group (P < 0.05). Conclusion Tanreqing Injection combined with Sivelestat Sodium for injection can provide therapeutic effects in treatment of acute respiratory distress syndrome, reduce the severity of the disease, improve blood gas indexes, and reduce inflammatory response.

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