目的 探讨血必净注射液联合地塞米松磷酸钠注射液治疗重症脓毒症的临床疗效。方法 选取2023年1～12月重庆大学附属涪陵医院收治的66例重症脓毒症患者临床资料，根据用药方案不同分为对照组和治疗组，各33例。对照组静脉滴注地塞米松磷酸钠注射液，10 mg地塞米松注射液与250 mL 5%葡萄糖混合，1次/d。治疗组在对照组基础上静脉滴注血必净注射液，100 mL血必净注射液与250 mL 5%葡萄糖混合，2次/d。两组共治疗1周。比较两组临床疗效、临床症状改善时间、疾病严重程度、血清炎症因子。结果 治疗后，治疗组的总有效率为90.91%，高于对照组总有效率63.64%（P＜0.05）。治疗后，治疗组完成复苏时间、血压复常时间、体温恢复时间均短于对照组（P＜0.05）。治疗后，两组急性生理学与慢性健康状况评价系统Ⅱ（APACHE bⅡ）评分均低于治疗前（P＜0.05），且治疗组患者的APACHEⅡ评分低于对照组（P＜0.05）。治疗后，两组血清白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）水平均低于治疗前（P＜0.05），且治疗组血清CRP、IL-6、TNF-α水平低于对照组（P＜0.05）。结论 重症脓毒症采用血必净注射液联合地塞米松磷酸钠注射液治疗的疗效显著，可缩短患者临床症状改善时间，降低患者病情严重程度和炎症水平。

Objective To explore the therapeutic effect of Xuebijing Injection combined with Dexamethasone Sodium Phosphate Injection in treatment of severe sepsis. Methods Patients (66 cases) with severe sepsis in Chongqing University Fuling Hospital from January to December 2023 were divided into control and treatment groups according to different medication plans, and each group had 33 cases. Patients in the control group were iv administered with Dexamethasone Sodium Phosphate Injection, 10 mg added into 5% glucose solution 250 mL, once daily. Patients in the treatment group were iv administered with Xuebijing Injection on the basis of the control group, 100 mL added into 5% glucose solution 250 mL, twice daily. Patients in two groups were treated for 1 week. The clinical efficacies, clinical symptom improvement time, disease severity, and inflammatory factors serum levels in two groups were compared. Results After treatment, the total effective rate of the treatment group was 90.91%, which was higher than 63.64% of the control group (P < 0.05). After treatment, the recovery time, blood pressure normalization time, and body temperature recovery time of the treatment group were shorter than those of the control group (P < 0.05). After treatment, APACHE II scores of two groups were lower than those before treatment (P < 0.05), and APACHE II scores of the treatment group were lower than those of the control group (P< 0.05). After treatment, the serum levels of CRP, IL-6, and TNF-α in two groups were decreased (P< 0.05), and the serum levels of CRP, IL-6, and TNF-α in treatment group were lower than those in control group (P < 0.05). Conclusion Xuebijing Injection combined with Dexamethasone Sodium Phosphate Injection in treatment of severe sepsis has a significant therapeutic effect, can shorten the time for clinical symptom improvement, reduce the severity of patients’ disease and the level of inflammation.

R977

重庆市自然科学基金资助项目（cstc2021jcyj-msxmX0628）；重庆市卫计委中医药科研项目（2023WSJK139）