目的 探讨痰热清注射液联合注射用西维来司他钠治疗急性呼吸窘迫综合征的疗效。方法 选择2022年12月—2024年12月在青岛市第八人民医院就诊的86例急性呼吸窘迫综合征患者，所有患者按随机数字表法分为对照组和治疗组，每组43例。对照组静脉滴注注射用西维来司他钠，每日4.8 mg/kg，加入250 mL生理盐水24 h持续静脉给药。治疗组在对照组基础上静脉滴注痰热清注射液，1次/d，每次20 mL加入500 mL葡萄糖注射液充分稀释后滴注。两组持续治疗7 d。比较两组的临床疗效、病情严重程度、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74.42%、90.70%，组间比较差异具有统计学意义（P＜0.05）。两组治疗后急性生理和慢性健康评估（APACHE）Ⅱ评分均显著降低（P＜0.05），且治疗组治疗后的APACHE Ⅱ评分低于对照组（P＜0.05）。两组患者治疗后的氧合指数、肺动态顺应性、气道峰值显著升高（P＜0.05），治疗组治疗后的氧合指数、肺动态顺应性、气道峰值高于对照组（P＜0.05）。两组治疗后的血清CD5抗原样蛋白（CD5L）、可溶性基质裂解素2（sST2）、激活素A（Activin-A）水平均降低（P＜0.05），治疗组治疗后的血清CD5L、sST2、Activin-A水平低于对照组（P＜0.05）。结论 痰热清注射液联合注射用西维来司他钠可提高急性呼吸窘迫综合征的临床疗效，减轻病情严重程度，改善血气指标，减轻炎症反应。

Objective To explore the clinical efficacy of Tanreqing Injection combined with Sivelestat Sodium for injection in treatment of acute respiratory distress syndrome. Methods A total of 86 patients with acute respiratory distress syndrome who were treated at Qingdao Eighth People’s Hospital from December 2022 to December 2024 were selected. All patients were randomly divided into control group and treatment group using a random number table method, with 43 cases in each group. Patients in the control group received intravenous infusion of Sivelestat Sodium for injection, with a daily dose of 4.8 mg/kg, and 250 mL of physiological saline was added for 24 h of continuous intravenous administration. Patients in the treatment group were intravenously infused with Tanreqing Injection on the basis of the control group, once daily, with 20 mL added each time and 500 mL glucose injection diluted thoroughly before infusion. Two groups of patients were treated continuously for 7 d. The clinical efficacy, severity of the condition, 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 74.42% and 90.70%, respectively, and the difference was statistically significant between two groups (P < 0.05). After treatment, APACHE II scores in two groups significantly decreased (P < 0.05), and the APACHE II scores in the treatment group was lower than those in the control group (P < 0.05). After treatment, the oxygenation index, lung dynamic compliance, and peak airway value significantly increased in two groups (P < 0.05), and the oxygenation index, lung dynamic compliance, and peak airway value in the treatment group were higher than those in the control group (P < 0.05). After treatment, the serum levels of CD5L, sST2, and Activin-A in both groups were decreased (P < 0.05). The levels of serum CD5L, sST2, and Activin-A in the treatment group were lower than those in the control group (P < 0.05). Conclusion Tanreqing Injection combined with Sivelestat Sodium for injection can provide therapeutic effects in treatment of acute respiratory distress syndrome, reduce the severity of the disease, improve blood gas indexes, and reduce inflammatory response.

R974