目的 观察宣肺败毒颗粒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 选取2025年1—10月南阳市第二人民医院收治的86例重症肺炎患者作为研究对象，采用计算机生成随机数字序列按1∶1比例分为对照组和治疗组，每组43例。对照组静脉滴注注射用亚胺培南西司他丁钠，1.0 g/次，每8小时1次。治疗组在对照组治疗基础上冲服宣肺败毒颗粒，1袋/次，2次/d。两组均治疗2周。比较两组临床疗效、感染程度、疾病严重程度、动脉血气指标、血清炎症介质。结果 治疗后，治疗组总有效率高于对照组（P＜0.05）。治疗后，两组肺炎胸片吸收评价量表（PCRAES）、临床肺部感染评分（CPIS）、急性生理与慢性健康评分（APACHEⅡ）评分较治疗前均降低（P＜0.05），且治疗组PCRAES、CPIS、APACHEⅡ评分均低于对照组（P＜0.05）。治疗后，两组血氧饱和度（SaO₂）、动脉血氧分压（pO₂）、氧合指数（pO₂/FIO₂）较治疗前均升高，二氧化碳分压（pCO₂）较治疗前降低（P＜0.05），且治疗组SaO₂、pO₂、pO₂/FIO₂高于对照组，pCO₂低于对照组（P＜0.05）。治疗后，两组血清白细胞介素-6（IL-6）、超敏C反应蛋白（hs-CRP）、高迁移率族蛋白B1（HMGB1）、可溶性髓系细胞触发受体-1（sTREM-1）水平均较治疗前降低（P＜0.05），且治疗组血清IL-6、hs-CRP、HMGB1、sTREM-1水平均低于对照组（P＜0.05）。结论 宣肺败毒颗粒联合注射用亚胺培南西司他丁钠治疗重症肺炎可发挥协同增效作用，提高临床疗效，减轻感染和病情严重程度，改善氧合状态，抑制炎症反应。

Objective To observe the clinical efficacy of Xuanfei Baidu Granules combined with Imipenem and Cilastatin Sodium for injection in treatment of severe pneumonia. Methods A total of 86 patients with severe pneumonia admitted to Nanyang Second General Hospital from January 2025 to October 2025 were selected as the research subjects. A computer-generated random number sequence was used to divide them into control group and treatment group in a 1:1 ratio, with 43 patients in each group. The control group received intravenous infusion of Imipenem and Cilastatin Sodium for injection, 1.0 g/time, once every 8 hours. The treatment group took Xuanfei Baidu Granules orally on the basis of the control group treatment, 1 bag/time, 2 times daily. Two groups were treated for 2 weeks. The clinical efficacy, infection severity, disease severity, arterial blood gas indicators, and serum inflammatory mediators were compared between two groups. Results After treatment, the total effective rate of the treatment group was higher than that of the control group (P < 0.05). After treatment, the chest X-ray absorption evaluation scale (PCRAES), clinical pulmonary infection score (CPIS), and acute physiology and chronic health score (APACHE II) scores of two groups decreased (P < 0.05), and the PCRAES, CPIS, and APACHE II scores of the treatment group were lower than those of the control group (P< 0.05). After treatment, blood oxygen saturation (SaO₂), arterial partial pressure of oxygen (pO₂), and oxygenation index (pO₂/FIO₂) in two groups significant increased, while partial pressure of carbon dioxide (pCO₂) significantly decreased (P < 0.05). SaO₂, pO₂, and pO₂/FIO₂ in the treatment group were higher than those in the control group, while pCO₂ was lower than the control group (P < 0.05). After treatment, the serum levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), high mobility group protein B1 (HMGB1), and soluble myeloid cell trigger receptor-1 (sTREM-1) decreased in two groups (P < 0.05). The serum levels of IL-6, hs-CRP, HMGB1, and sTREM-1 in the treatment group were lower than those in the control group (P < 0.05). Conclusion The combination of Xuanfei Baodu Granules and Imipenem and Cilastatin Sodium for injection can synergistically enhance the treatment of severe pneumonia, improve clinical efficacy, alleviate infection and disease severity, improve oxygenation status, and inhibit inflammatory response.

R974

河南省医学科技攻关计划联合共建项目（LHGJ20210975）