目的 探讨痰热清注射液联合注射用头孢哌酮钠舒巴坦钠治疗重症肺炎的临床疗效。方法 选取2019年6月—2021年6月郑州大学第五附属医院收治的87例重症肺炎患者，按照随机数字表法将所有患者分为对照组（43例）和治疗组（44例）。对照组静脉滴注注射用头孢哌酮舒巴坦钠，3.0 g/次，2次/d。治疗组在对照组基础上静脉滴注痰热清注射液，20 mL加入500 mL葡萄糖注射液中，1次/d。两组患者连续治疗14 d。观察两组的治疗效果，比较两组患者主要症状的消失时间、肺部感染程度和血清炎症因子水平。结果 治疗后，治疗组患者的总有效率（95.45%）高于对照组的总有效率（81.40%）（P<0.05）。治疗后，治疗组发热、咳嗽、肺啰音、肺部阴影消失时间均短于对照组（P<0.05）。治疗后，两组的临床肺部感染评分（CPIS）显著降低（P<0.05），且治疗组CPIS明显低于对照组（P<0.05）。治疗后，两组的中性粒细胞与淋巴细胞比值（NLR）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）水平显著降低（P<0.05），且治疗组NLR、IL-6、IL-8水平比对照组降低更明显（P<0.05）。结论 痰热清注射液联合注射用头孢哌酮钠舒巴坦钠可提高重症肺炎的临床疗效，能加快主要症状改善，减轻肺感染程度和炎症反应，药物安全性良好。

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

河南省医学科技攻关计划项目（2018020243）