目的 探讨参附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4月-2022年12月重庆市江北区中医院收治的120例重症肺炎患者，根据随机数字表法将所有患者分为对照组和治疗组，每组各60例。对照组静脉滴注注射用头孢哌酮钠舒巴坦钠，3支加入100 mL生理盐水充分稀释后滴注，1次/12 h。治疗组在对照组基础上静脉滴注参附注射液，50 mL/次，然后以20 mL/h持续泵注50 mL，1次/12 h。两组患者连续治疗14 d。观察两组的临床疗效，比较两组患者的高热、咳嗽、气喘、肺部阴影消失时间，以及血氧分压、氧合指数、血氧饱和度、D-二聚体、纤维蛋白原、中性粒细胞-淋巴细胞比值（NLR）。结果 治疗后，治疗组患者总有效率95.00%高于对照的总有效率83.33%，组间比较差异显著（P<0.05）。治疗后，治疗组患者高热、咳嗽、气喘、肺部阴影消失时间均短于对照组，差异有统计学意义（P<0.05）。治疗后，两组的血氧分压、氧合指数、血氧饱和度高于治疗前（P<0.05），治疗组的血氧分压、氧合指数、血氧饱和度高于对照组（P<0.05）。治疗后，两组的血清D-二聚体、纤维蛋白原、NLR低于治疗前（P<0.05），且治疗组的D-二聚体、纤维蛋白原、NLR明显低于对照组（P<0.05）。结论 参附注射液联合注射用头孢哌酮钠舒巴坦钠治疗重症肺炎的疗效确切，能改善临床症状和肺通气功能，降低炎症反应和血液高凝状态。

Objective To investigate the clinical effect of Shenfu Injection combined with Cefoperazone Sodium and Sulbactam Sodium for injection in treatment of severe pneumonia. Methods Patients (120 cases) with severe pneumonia in Chongqing Jiangbei District Hospital of Traditional Chinese Medicine from April 2019 to December 2022 were divided into control and treatment groups according to the random number table method, and each group had 60 cases. Patients in the control group were iv administered with Cefoperazone Sodium and Sulbactam Sodium for injection, 3 bottles added into normal saline 100 mL, once every 12 h. Patients in the treatment group were iv administered with Shenfu Injection on the basis of the control group, 50 mL/time, then continuously pump 50 mL at 20 mL/h, once every 12 h. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and the disappearance times of high temperature, cough, asthma and lung shadow, the blood oxygen partial pressure, oxygenation index, blood oxygen saturation, D-dimer, fibrinogen and NLR in two groups were compared. Results After treatment, the total effective rate (95.00%) in the treatment group was higher than that (83.33%) in the control group, with a significant difference between two groups (P< 0.05). After treatment, the disappearance times of high temperature, cough, asthma, and lung shadows in the treatment group was shorter than that in the control group, and the difference was statistically significant (P < 0.05). After treatment, the blood oxygen partial pressure, oxygenation index, and blood oxygen saturation of two groups were higher than those before treatment (P < 0.05), and the blood oxygen partial pressure, oxygenation index, and blood oxygen saturation of the treatment group were higher than those of the control group (P < 0.05). After treatment, D-dimer, fibrinogen, and NLR of two groups were lower than those before treatment (P < 0.05), and the D-dimer, fibrinogen, and NLR of the treatment group were lower than those of the control group (P < 0.05). Conclusion Shenfu Injection combined with Cefoperazone Sodium and Sulbactam Sodium for injection has definite efficacy in treatment of severe pneumonia, which can improve clinical symptoms and lung ventilation function, reduce inflammatory reactions and blood hypercoagulability.

R974

重庆市卫生计生委医学科研计划项目（2015ZBXM042）