目的 考察热毒宁注射液联合注射用亚胺培南西司他丁钠治疗重症肺炎的临床疗效。方法 选择2020年7月—2023年2月在南京市中西医结合医院就诊的94例重症肺炎患者作为研究对象，参考随机数字表法将94例患者分为对照组（n＝47）和治疗组（n＝47）。对照组静脉滴注注射用亚胺培南西司他丁钠，1.0 g加入100 mL生理盐水中，1次/12 h。治疗组在对照组治疗的基础上静脉滴注热毒宁注射液，20 mL热毒宁注射液加入250 mL葡萄糖溶液中，滴速30～60滴/min，1次/d。两组连续治疗10 d。对比两组患者临床疗效、病情严重程度、症状消失时间、肺通气功能、血清指标。结果 治疗后，治疗组总有效率与对照组的总有效率组间比较差异显著（P＜0.05）。治疗后，两组的序贯性脏器功能衰竭（SOFA）评分显著减少（P＜0.05），治疗组的SOFA评分小于对照组（P＜0.05）。治疗后，治疗组高热、咳嗽、喘息、肺啰音消失时间明显短于对照组（P＜0.05）。治疗后，两组的气道阻力、吸气峰压、平均气道压显著降低（P＜0.05），治疗组气道阻力、吸气峰压、平均气道压明显低于对照组（P＜0.05）。治疗后，两组的血清高迁移率族蛋白B1（HMGB1）、白细胞介素-18（IL-18）、可溶性髓系细胞触发受体-1（sTREM-1）水平均显著降低（P＜0.05），治疗组的血清HMGB1、IL-18、sTREM-1水平明显低于对照组（P＜0.05）。结论 热毒宁注射液联合注射用亚胺培南西司他丁钠可显著提高重症肺炎的临床疗效，缓解患者的临床症状和病情严重程度，改善肺通气功能，显著减轻炎症反应。

Objective To investigate the clinical effect of Reduning Injection combined with Imipenem and Cilastatin Sodium for injection in treatment of severe pneumonia. Methods Patients (94 cases) with severe pneumonia in Nanjing Integrated Traditional Chinese and Western Medicine Hospital from July 2020 to February 2023 were divided into control group (n＝47) and treatment group (n＝47) according to random number table method. Patients in the control group were iv administered with Imipenem and Cilastatin Sodium for injection, 1.0 g added into 100 mL normal saline, once per 12 h. Patients in the treatment group were iv administered with Reduning Injection on the basis of the control group, 20 mL Reduning Injectioadded into glucose solution 250 mL, dropping rate 30 — 60 drops/min, once daily. Patients in two groups were treated for 10 d. The clinical efficacies, severity of the disease, symptom disappearance time, lung ventilation function, and serum factors in two groups were compared. Results After treatment, the total effective rate of the treatment group had significant differences with that of the control group (P < 0.05). After treatment, SOFA scores of two groups were significantly decreased (P < 0.05), and SOFA score of the treatment group was lower than that of the control group (P < 0.05). After treatment, the disappearance time of high fever, cough, wheezing, and lung rales in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the airway resistance, peak inspiratory pressure, and average airway pressure of two groups were significantly reduced (P < 0.05), and the airway resistance, peak inspiratory pressure, and average airway pressure of the treatment group were significantly lower than those of the control group (P < 0.05). After treatment, the serum levels of HMGB1, IL-18, and sTREM-1 in two groups were significantly reduced (P < 0.05), and the serum levels of HMGB1, IL-18, and sTREM-1 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Reduning injection combined with Imipenem and Cilastatin Sodium for injection can significantly improve the clinical efficacy of severe pneumonia, reduce clinical symptoms and severity of the disease, improve lung ventilation function, significantly reduce inflammation.

R974

南京市科技计划项目（202110032）