目的 探讨胸腺肽α1联合氢化可的松注射液治疗脓毒症休克的临床疗效。方法 收集2014年3月-2017年3月在承德市中医院治疗的脓毒症休克患者72例，根据用药差别分为对照组（36例）和治疗组（36例）。对照组静脉滴注氢化可的松注射液，50 mg加入生理盐水100 mL，1次/6 h。治疗组在对照组基础上皮下注射注射用胸腺肽α1，10 mg加入生理盐水1 mL，1次/d。两组均经过10 d治疗。评价两组患者临床疗效，同时比较治疗前后两组患者血清学指标和APACHEⅡ评分改善情况。结果 治疗后，治疗组总有效率和病死率分别为83.33%、8.82%，均分别显著优于对照组的61.11%、32.14%；两组比较差异均具有统计学意义（P<0.05）。治疗后，两组血清降钙素原（PCT）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、TOLL样受体4（TLR4）和Toll/IL-1受体衔接蛋白（TIRAP）水平均明显降低，同组比较差异具有统计学意义（P<0.05）；且治疗组比对照组降低更显著，两组比较差异具有统计学意义（P<0.05）。治疗后，两组APACHEⅡ评分均显著降低，同组比较差异具有统计学意义（P<0.05）；且治疗组APACHEⅡ评分显著低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 胸腺肽α1联合氢化可的松注射液治疗脓毒症休克可有效降低机体炎症反应和APACHEⅡ评分，临床疗效较好，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of thymosin α1 combined with hydrocortisone in treatment of septic shock. Methods Patients (72 cases) with septic shock in Chengde Hospital of TCM from March 2014 to March 2017 were divided into control (36 cases) and treatment (36 cases) groups according to different treatments. Patients in the control group were iv administered with Hydrocortisone Injection, 50 mg added into normal saline 100 mL, once every 6 h. Patients in the treatment group were subcutaneous injection administered with Thymosin α1 for injection on the basis of the control group, 10 mg added into normal saline 1 mL, once daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacy was evaluated, and the 28 d mortality rates, serological indexes and APACHEⅡ score in two groups before and after treatment were compared. Results After treatment, clinical efficacy and mortality rates in the treatment group were 83.33% and 8.82%, which were significantly better than 61.11% and 32.14% in the control group, respectively, and there were differences between two groups (P<0.05). After treatment, the PCT, TNF-α, IL-1β, TLR4, and TIRAP level in two groups were obviously decreased, and the difference was statistically significant in the same group (P<0.05). And these serological indexes in the treatment group decreased more significantly than that the control group, with significant difference between two groups (P<0.05). After treatment, the APACHEⅡ score in two groups was significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the APACHE score Ⅱ in the treatment group was obviously lower than that in the control group, with significant difference between two groups (P<0.05). Conclusion Thymosin α1 combined with hydrocortisone can effectively reduce inflammatory response and APACHEⅡ score in treatment of septic shock with good clinical efficacy, which has a certain clinical application value.