目的 探讨贞芪扶正颗粒联合注射用亚胺培南西司他丁钠治疗重症肺炎的疗效。方法 选取2024年1月—2024年12月新疆医科大学第一附属医院82例重症肺炎患者，将所有患者按随机数字表法分为对照组和治疗组，每组各41例。对照组静滴注射用亚胺培南西司他丁钠，1 g/次，3次/d。治疗组在对照组基础上冲服贞芪扶正颗粒，1袋/次，2次/d。两组患者持续治疗2周。比较两组的治疗效果、症状消失时间、病情程度、血气指标、血清炎症指标。结果 对照组、治疗组的总有效率分别为80.49%、95.12%，组间总有效率的差异有统计学意义（P＜0.05）。治疗组的体温复常时间、咳嗽消失时间、肺啰音消失时间、痰液消失时间均短于对照组（P＜0.05）。治疗后，两组的临床肺部感染评分（CPIS）显著降低（P＜0.05），且治疗组的CPIS明显低于对照组（P＜0.05）。两组治疗后的氧合指数高于治疗前，二氧化碳分压低于治疗前（P＜0.05）；治疗组治疗后的氧合指数高于对照组，二氧化碳分压低于对照组（P＜0.05）。两组治疗后的可溶性细胞黏附分子（sICAM-1）、白细胞介素-23（IL-23）、CD64显著降低（P＜0.05）；与对照组治疗后比较，治疗组治疗后的sICAM-1、IL-23、CD64更低（P＜0.05）。结论 重症肺炎患者经贞芪扶正颗粒联合注射用亚胺培南西司他丁钠治疗，可提高临床疗效，减轻病情，调节血气指标，降低炎症反应。

Objective To investigate the efficacy of Zhenqi Fuzheng Granules combined with Imipenem and Cilastatin Sodium for injection in treatment of severe pneumonia. Methods 82 Severe pneumonia patients from the First Affiliated Hospital of Xinjiang Medical University from January 2024 to December 2024 were select, and all patients were divide into control group and treatment group using the random number table method, with 41 patients in each group. The control group received intravenous infusion of Imipenem and Cilastatin Sodium for injection, 1 g/time, 3 times daily. On the basis of the control group, patients in the treatment group were given Zhenqi Fuzheng Granules orally with one bag each time, twice daily. Two groups completed continuous treatment for 2 weeks. The treatment efficacy, symptom disappearance time, severity of illness, blood gas indicators, and serum inflammation indicators were compared between two groups. Results The total effective rates of the control group and the treatment group were 80.49% and 95.12%, respectively, and the difference in total effective rates was statistically significant between two groups (P < 0.05). The recovery time of body temperature, disappearance time of cough, disappearance time of lung rales, and disappearance time of sputum in the treatment group were all shorter than those in the control group (P < 0.05). After treatment, the Clinical Pulmonary Infection Score (CPIS) in both groups significantly decreased (P < 0.05), and the CPIS of the treatment group was significantly lower than that of the control group (P < 0.05). The oxygenation index of both groups after treatment was higher than those before treatment, but the partial pressure of carbon dioxide was lower than those before treatment (P < 0.05). The oxygenation index of the treatment group was higher than that of the control group after treatment, but the partial pressure of carbon dioxide was lower than that of the control group (P < 0.05). After treatment, soluble cell adhesion molecule-1 (sICAM-1), interleukin-23 (IL-23), and CD64 were significantly reduced in two groups (P < 0.05), and the treatment group had lower levels of sICAM-1, IL-23, and CD64 compared with the control group after treatment (P < 0.05). Conclusion The combination of Zhenqi Fuzheng Granules and Imipenem and Cilastatin Sodium for injection in treatment of severe pneumonia can improve clinical efficacy, alleviate symptoms, regulate blood gas indicators, and reduce inflammatory reactions.

R974

新疆医科大学第一附属医院“青年科研起航”专项基金资助项目（2022YFY-QKQN-95）