目的 探讨血必净辅助治疗重症肺炎的疗效及对患者肾功能和血清Th1/Th2细胞因子的影响。方法 取2015年1月-2017年2月南阳医学高等专科学校第一附属医院诊治的196例重症肺炎患者，根据随机数字表法分为对照组和观察组各98例。均给予吸氧、化痰和营养支持等常规指标和抗生素治疗；观察组在此基础上给予血必净治疗，连续治疗1周。比较两组的疗效，治疗前后的肾功能指标水平以及血清Th1/Th2细胞因子水平。结果 观察组的治疗总有效率为94.90%，高于对照组的78.57%，差异有统计学意义（P < 0.05）。治疗前，两组的血肌酐（SCr）、血尿素氮（BUN）和内生肌酐清除率（Ccr）水平差异无统计学意义；治疗后，对照组的SCr、BUN水平略高于治疗前，Ccr水平略低于治疗前但不具统计学差异，而观察组的SCr、BUN水平高于治疗前，Ccr水平低于治疗前，差异有统计学意义（P < 0.05）；治疗后观察组的SCr、BUN水平高于对照组，且Ccr水平低于对照组，差异有统计学意义（P < 0.05）。治疗前，两组的干扰素-γ（INF-γ）和白细胞介素-4（IL-4）水平和INF-γ/IL-4差异无统计学意义；治疗后两组的INF-γ水平、INF-γ/IL-4高于治疗前，IL-4水平低于治疗前，同组治疗前后比较差异有统计学意义（P < 0.05）；且治疗后观察组的INF-γ水平、INF-γ/IL-4高于对照组，IL-4水平低于对照组，差异有统计学意义（P < 0.05）。结论 血必净联合抗生素治疗重症肺炎效果明显，有利于保护肾脏功能，调节血清Th1/Th2细胞因子水平，增强免疫力。

Objective To discuss the effect of Xuebijing combined antibiotics on the efficacy, renal function and Th1/Th2 cytokines of severe pneumonia patients. Methods A total of 196 severe pneumonia patients treated in Nanyang Station South Road Medical Special Hospital from January 2015 to February 2017 were studied. All patients were treated with routine indicators such as oxygen absorption, phlegm and nutrition support and antibiotic therapy. On this basis, observation group was given Xuebijing therapy. The efficacy, renal function and Th1/Th2 cytokines before and after treatment were compared. Results The total effective rate of observation group was higher than control group (P < 0.05). Before treatment, the difference in SCr, BUN and Ccr levels of two groups was no statistically significant, the SCr, BUN levels of observation group were higher and Ccr level was lower than those of control group after treatment (P < 0.05), the SCr, BUN levels of observation group after treatment were higher and Ccr level was lower than those before treatment (P < 0.05), the SCr, BUN levels of control group after treatment were slightly higher and Ccr level was slightly lower than those before treatment (P < 0.05) but the difference showed no statistically significant. Before treatment, the difference in INF-γ, IL-4 levels and INF-γ/IL-4 of two groups showed no statistically significant, the INF-γlevel and INF-γ/IL-4 of two groups were higher and IL-4 level was lower than those before treatment (P < 0.05). After treatment, the INF-γlevel and INF-γ/IL-4 of observation group were higher and IL-4 level was lower than control group (P < 0.05). Conclusion The effective treatment of Xuebijing combined antibiotics is obvious, is beneficial to protectrenal function and regulate serum Th1/Th2 cytokines level and enhance immunity.