目的 探讨复方鲜竹沥液联合哌拉西林钠舒巴坦钠治疗社区获得性肺炎的临床疗效。方法 选取2021年1月—2024年1月首都医科大学附属北京同仁医院收治的102例社区获得性肺炎患者，按随机数字表法将患者分为对照组和治疗组，每组各51例。对照组静脉滴注注射用哌拉西林钠他唑巴坦钠，以0.9%氯化钠溶液将4.5 g本品溶解后，再加入同一溶媒稀释至100 mL，缓慢滴注30 min以上，3次/d。治疗组在对照组治疗基础上口服复方鲜竹沥液，20 mL/次，3次/d。两组疗程都为10 d。观察两组临床疗效和临床表现消失时间，比较治疗前后相关量表[社区获得性肺炎严重程度（CURB-65）评分、肺炎胸片吸收评价量表（PCRAES）评分、肺炎严重指数（PSI）评分]、氧合指数（OI）和呼吸频率（RR）及红细胞分布宽度（RDW）、白细胞介素（IL）-8、IL-17等炎症指标水平。结果 治疗后，治疗组总有效率是96.08%，显著高于对照组的84.31%（P＜0.05）。治疗后，治疗组咳嗽、咳痰、胸闷痛、发热、肺部啰音的消失时间都短于对照组（P＜0.05）。治疗后，两组CURB-65、PCRAES和PSI评分都显著降低（P＜0.05）；治疗后，治疗组CURB-65、PCRAES和PSI评分低于对照组（P＜0.05）。治疗后，两组OI显著升高，而RR都显著降低（P＜0.05）；治疗后，治疗组OI高于对照组，而RR低于对照组（P＜0.05）。治疗后，两组NLR、RDW和血清CRP、IL-8、IL-17水平都低于治疗前（P＜0.05）；治疗后，治疗组NLR、RDW、CRP、IL-8、IL-17水平都低于对照组（P＜0.05）。结论 在哌拉西林钠舒巴坦钠治疗社区获得性肺炎基础上加用复方鲜竹沥液，能有效加快患者临床表现消除，促进肺部感染和病情严重程度的减轻，改善呼吸功能，进一步控制机体炎症状态。

Objective To explore the clinical efficacy of Compound Xianzhuli Liquids combined with piperacillin sodium and sulbactam sodium in treatment of community-acquired pneumonia. Methods A total of 102 patients with community-acquired pneumonia admitted to Beijing Tongren Hospital, Capital Medical University from January 2021 to January 2024 were selected and divided into control group and treatment group according to random number table method, with 51 cases in each group. Patients in control group were iv administered with Piperacillin Sodium and Sulbactam Sodium for injection, dissolved 4.5g of this product with 0.9% Nacl solution, then added the same solvent to dilute to 100 mL, slowly infused for more than 30 min, 3 times daily. Patients in treatment group were po administered with Compound Xianzhuli Liquids on the basis of the control group, 20 mL/time, three times daily. Both groups were treated for 10 d. The clinical efficacy and disappearance time of clinical manifestations of two groups were observed. The relevant scales (CURB-65 score, PCRAES score, PSI score), oxygenation index (OI), respiratory rate (RR), red blood cell distribution width (RDW), IL-8, IL-17 were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 96.08%, which was significantly higher than that of the control group (84.31%, P < 0.05). After treatment, the disappearance time of cough, expectoration, chest pain, fever and lung rales in treatment group was shorter than those in control group (P< 0.05). After treatment, the CURB-65, PCRAES and PSI scores in both groups were significantly decreased (P < 0.05). After treatment, the CURB-65, PCRAES, and PSI scores in treatment group were lower than those in control group (P < 0.05). After treatment, OI was significantly increased, but RR was significantly decreased in both groups (P < 0.05). After treatment, OI in treatment group was higher than that in control group, but RR was lower than that in control group (P < 0.05). After treatment, the levels of NLR, RDW and serum CRP, IL-8, and IL-17 in both groups were lower than those before treatment (P < 0.05). After treatment, the levels of NLR, RDW, CRP, IL-8, and IL-17 in treatment group were lower than those in control group (P < 0.05). Conclusion On the basis of piperacillin sodium and sulbactam sodium in treatment of community-acquired pneumonia, the addition of Compound Xianzhuli Liquids can effectively accelerate the elimination of clinical manifestations of patients, and can promote the reduction of lung infection and disease severity, improve respiratory function, which further control the inflammatory state of the body.

R974