目的 探讨热毒宁注射液联合注射用哌拉西林钠他唑巴坦钠治疗重症肺炎临床疗效。方法 选取2019年9月—2022年4月河南省人民医院收治的86例重症肺炎患者，依据随机数字表法将所有患者分为对照组和治疗组，每组各43例。对照组静脉滴注注射用哌拉西林钠他唑巴坦钠，4.5g加入100mL生理盐水中，每12小时1次。治疗组在对照组基础上静脉滴注热毒宁注射液，20mL加入250mL生理盐水中，1次/d。两组患者连续治疗14d。观察两组的临床疗效，比较两组症状的消失时间、病情程度、氧合指数、血氧分压、氧饱和度、C反应蛋白（CRP）/白蛋白（ALB）、克拉拉细胞蛋白16（CC16）、中性粒细胞与淋巴细胞的比值（NLR）。结果 治疗后，治疗组的总有效率为95.35%，对照组的总有效率为81.40%，组间比较差异有统计学意义（P＜0.05）。治疗后，治疗组的体温复常时间、咳嗽、肺啰音、肺阴影消失时间、住院时间均短于对照组，差异有统计学意义（P＜0.05）。治疗后，两组急性生理学与慢性健康状况（APACHE Ⅱ）评分低于治疗前（P＜0.05），且治疗组的APACHE Ⅱ评分低于对照组，差异有统计学意义（P＜0.05）。治疗后，两组的氧合指数、血氧分压、氧饱和度高于治疗前（P＜0.05），治疗组氧合指数、血氧分压、氧饱和度明显高于对照组（P＜0.05）。治疗后，两组的CRP/ALB、CC16、NLR低于治疗前（P＜0.05），治疗组的CRP/ALB、CC16、NLR低于对照组，差异有统计学意义（P＜0.05）。结论 热毒宁注射液联合注射用哌拉西林钠他唑巴坦钠可提高重症肺炎的临床疗效，改善临床症状和通气功能，降低炎症反应，且安全性良好。

Objective To investigate the clinical efficacy of Reduning Injection combined with Piperacillin Sodium and Tazobactam Sodium for injection in treatment of severe pneumonia. Methods Patients (86 cases) with severe pneumonia in Henan Provincial People's Hospital from September 2019 to April 2022 were divided into control and treatment groups according to random number table method, and each group had 43 cases. Patients in the control group were iv administered with Piperacillin Sodium and Tazobactam Sodium for injection, 4.5g added into normal saline 100 mL, once every 12 h. Patients in the treatment group were iv administered with Reduning Injection on the basis of the control group, 20 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and the disappearance time of symptoms, the degree of illness, the oxygenation index, blood oxygen partial pressure, and oxygen saturation, CRP/ALB, CC16 and NLR in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.35%, and that of the control group was 81.40%, and the difference was statistically significant between two groups (P<0.05). After treatment, the temperature normalization time, the disappearance time of cough, rale, lung shadow, and the hospitalization time of the treatment group were shorter than those of the control group, and the difference was statistically significant (P<0.05). After treatment, the APACHE Ⅱ of two groups was lower than that before treatment (P<0.05), and the APACHE Ⅱ score of the treatment group was lower than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the oxygenation index, blood oxygen partial pressure, and oxygen saturation of two groups were higher than those before treatment (P<0.05), and the oxygenation index, blood oxygen partial pressure and oxygen saturation of the treatment group were significantly higher than those of the control group (P<0.05). After treatment, the CRP/ALB, CC16, and NLR of the two groups were lower than those before treatment (P<0.05), and the CRP/ALB, CC16, and NLR of the treatment group were lower than those of the control group (P<0.05). Conclusion Reduening Injection combined with Piperacillin Sodium and Tazobactam Sodium for injection has clinical curative effect in treatment of severe pneumonia, improve clinical symptoms and ventilation function, reduce inflammatory reaction, with good safety.

R974

河南省医学科技攻关计划项目（201702228）