目的 研究血必净注射液联合盐酸莫西沙星氯化钠注射液治疗重症肺炎的临床疗效。方法 选取2018年9月—2019年9月在天津市北辰医院治疗的120例重症肺炎患者，将所有患者随机分为对照组和治疗组，每组各60例。对照组患者静脉滴注盐酸莫西沙星氯化钠注射液，0.4 g/次，1次/d。治疗组在对照组基础上静脉滴注血必净注射液，50 mL溶于100 mL生理盐水，2次/d。两组患者持续治疗14 d。观察两组的临床疗效，比较两组的临床症状缓解时间、急性生理与慢性健康评分表（APACHE Ⅱ）评分、血气指标和血清炎性指标。结果 治疗后，治疗组总有效率（96.67%）明显高于对照组（81.67%）（P<0.05）。治疗后，两组患者APACHE Ⅱ评分显著降低（P<0.05）；且治疗组APACHE Ⅱ评分降低较多（P<0.05）。治疗后，治疗组患者咳嗽消失时间、啰音消失时间、体温恢复正常时间、白细胞恢复正常时间显著短于对照组（P<0.05）。治疗后，两组血氧分压（pO₂）水平显著上升，二氧化碳分压（pCO₂）水平显著下降（P<0.05），且治疗组血气指标改善较多（P<0.05）。治疗后，两组血清超敏C反应蛋白（hs-CRP）、降钙素（PCT）、白细胞介素-1β（IL-1β）水平显著降低（P<0.05）；并且治疗组血清hs-CRP、PCT、IL-1β水平降低较多（P<0.05）。结论 血必净注射液联合盐酸莫西沙星氯化钠注射液治疗重症肺炎具有较好的临床疗效，能改善临床症状和血气指标，降低血清炎性因子水平，值得在临床上推广应用。

Objective To study the efficacy of Xubijing Injection combined with Moxifloxacin Hydrochloride and Sodium Chloride Injection in treatment of severe pneumonia. Methods Patients (120 cases) with severe pneumonia in Tianjin Beichen Hospital from September 2018 to September 2015 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were iv administered with Moxifloxacin Hydrochloride and Sodium Chloride Injection, 0.4 g/time, once daily. Patients in the treatment group were iv administered with Xubijing Injection on the basis of the control group, 50 mL added into normal saline 100 mL, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and clinical symptom relief time, acute physiology and chronic health evaluation (APACHE) Ⅱ, blood gas index, and serum inflammatory index in two groups were compared. Results After treatment, the total effective rate of the treatment group (96.67%) was significantly higher than that of the control group (81.67%) (P<0.05). After treatment, the remission times of cough, rales, body temperature, and leukocyte in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, pO₂ in two groups were significantly increased, but pCO₂ were significantly decreased (P<0.05), and the blood gas indexes of the treatment group were significantly better than those of the control group (P<0.05). After treatment, the serum levels of hs-CRP, PCT, and IL-1β in the two groups were significantly decreased (P<0.05), and the serum levels of hs-CRP, PCT and IL-1β in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Xubijing Injection combined with Moxifloxacin Hydrochloride and Sodium Chloride Injection has clinical curative effect in treatment of severe pneumonia, can improve the clinical symptoms and blood gas index, and reduce the serum level of inflammatory factors, which is worthy of clinical application.

R974

天津市北辰区科技发展计划项目（BCWS2014-14）