目的 探讨参麦注射液联合哌拉西林钠他唑巴坦钠治疗脓毒症的临床疗效。方法 纳入2023年4月—2025年10月首都医科大学附属北京友谊医院收治的125例脓毒症患者的病例资料，进行回顾性分析。按治疗方案不同分为对照组（62例）和治疗组（63例）。对照组采用注射用哌拉西林钠他唑巴坦钠治疗，4.5 g/次，以适量0.9%氯化钠注射液溶解后，加入100 mL 0.9%氯化钠注射液中，静脉滴注时间≥30 min/次，每8小时1次。治疗组在对照组治疗基础上联合使用参麦注射液，100 mL/次，用5%葡萄糖注射液250 mL稀释后静脉滴注，1次/d。两组疗程均为7 d。观察两组患者临床疗效及临床改善时间，比较治疗前后急性生理和慢性健康状况评分Ⅱ（APACHE Ⅱ）、改良早期预警评分（MEWS）、序贯器官衰竭评估（SOFA）评分及中性粒细胞与淋巴细胞比值（NLR）、全身免疫炎症指数（SII）和血清C反应蛋白（CRP）、降钙素原（PCT）水平。结果 治疗后，治疗组总有效率87.30%显著高于对照组72.58%（P＜0.05）。治疗后，治疗组体温复常时间、血压复常时间、白细胞复常时间、尿量恢复时间、机械通气时间均显著短于对照组（P＜0.05）。治疗后，两组APACHE Ⅱ、MEWS和SOFA评分均较同组治疗前显著降低（P＜0.05）；且治疗后治疗组APACHE Ⅱ、MEWS和SOFA评分低于对照组（P＜0.05）。治疗后，两组NLR、SII和血清CRP、PCT水平均显著下降（P＜0.05）；且治疗后治疗组NLR、SII和血清CRP、PCT水平均低于对照组（P＜0.05）。结论 参麦注射液与哌拉西林钠他唑巴坦钠联用可显著缩短脓毒症患者临床指标恢复时间、降低病情严重程度评分及恶化风险，进一步降低炎症水平，且不增加不良反应风险，值得临床推广应用。

Objective To investigate the clinical efficacy of Shenmai Injection combined with piperacillin sodium and tazobactam sodium in treatment of sepsis.Methods The case data of 125 patients with sepsis who were admitted to Beijing Friendship Hospital Affiliated to Capital Medical University from April 2023 to October 2025 were included for a retrospective analysis. According to different treatment plans, they were divided into control group (62 cases) and treatment group (63 cases). Patients in control group were treated with Piperacillin Sodium and Tazobactam Sodium for injection, the dosage was 4.5 g/time, it was dissolved in an appropriate amount of 0.9% sodium chloride injection, then added to 100 mL of 0.9% sodium chloride injection for intravenous infusion for ≥ 30 min/time, and administered once every 8 h. Patients in treatment group were additionally treated with Shenmai Injection, 100 mL/time, diluted with 250 mL of 5% glucose injection for intravenous infusion, once daily. The treatment duration for both groups was 7 d. The clinical efficacy and time of clinical improvement of two groups were observed , and Acute Physiology and Chronic Health Evaluation II (APACHE II), Modified Early Warning Score (MEWS), Sequential Organ Failure Assessment (SOFA) scores, as well as the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammatory index (SII), and serum C-reactive protein (CRP) and procalcitonin (PCT) levels before and after treatment in two groups were compared. Results After treatment, the total effective rate of treatment group (87.30%) was significantly higher than that of control group (72.58%, P < 0.05). After treatment, time for body temperature to return to normal, blood pressure to return to normal, white blood cell count to return to normal, urine output to recover, and mechanical ventilation time in treatment group were significantly shorter than those in control group (P< 0.05). After treatment, the APACHE Ⅱ, MEWS and SOFA scores of both groups were significantly lower than those before treatment in same group (P< 0.05). And APACHE Ⅱ, MEWS, and SOFA scores of treatment group after treatment were lower than those of control group (P < 0.05). After treatment, the NLR, SII, and serum CRP and PCT levels of both groups significantly decreased (P < 0.05). And NLR, SII, and serum CRP and PCT levels of treatment group after treatment were lower than those of control group (P < 0.05). Conclusion The combination of Shenmai Injection and piperacillin sodium and tazobactam sodium can significantly shorten recovery time of clinical indicators in patients with sepsis, reduce the severity score and risk of deterioration condition, further lower the inflammatory level, and does not increase the risk of adverse reactions. Therefore, it is worthy of clinical promotion and application.

R978.7

国家中西医协同项目（ZDYN-2024-A-069）