目的 评价血必净注射液联合利奈唑胺治疗重症肺炎的有效性与安全性。方法 检索中国知网（CNKI）、万方数据库（Wanfang）、维普数据库（VIP）、中国生物医学文献数据库（CBM）、Cochrane Library、PubMed、Web of Science和Embase数据库，检索时限为各数据库建库至2022年6月，收集血必净注射液联合利奈唑胺治疗重症肺炎的随机对照试验，采用Review Manager 5.4.1对纳入文献进行质量评价、数据整合分析和偏倚风险评估；Stata14.0进行敏感性分析。结果 共纳入12项随机对照试验，涉及949例患者，观察组478例，对照组471例。Meta分析结果显示，观察组的临床总有效率 [RR＝1.24, 95% CI (1.18, 1.31), P<0.000 01]、细菌清除率 [RR＝1.38, 95% CI (1.22, 1.55), P<0.000 01] 显著高于对照组。观察组的血常规恢复正常时间 [MD＝−1.38, 95% CI (−1.55, −1.20), P<0.000 01]、体温恢复正常时间 [MD＝−1.68, 95% CI (−1.92, −1.44), P<0.000 01]、痰液颜色改变时间 [MD＝−1.24, 95% CI (−1.42, −1.05), P<0.000 01]、肺部炎症吸收>50%的时间 [MD＝−2.20, 95% CI (−2.66, −1.75), P<0.000 01] 明显短于对照组。观察组的肺部功能指标最大呼气中段流量 [MD＝0.55, 95% CI (0.51, 0.59), P<0.000 01]、第1秒用力呼气量占用力肺活量比值 [MD＝11.66, 95% CI (10.16, 13.16), P<0.000 01] 显著高于对照组，而呼气峰值流速[MD＝−10.92, 95% CI (−14.29, −7.56), P<0.000 01] 显著低于对照组，差异均有统计学意义。观察组发生不良反应 [RR＝0.99, 95% CI (0.57, 1.71), P＝0.96]相比于对照组无统计学差异。结论 在利奈唑胺的基础上联用血必净注射液可以显著提高重症肺炎的临床疗效。但由于纳入的文献质量总体不够高，对于治疗结果的有效性和安全性还需进一步开展更高质量的临床研究。

Objective To evaluate the efficacy and safety of Xuebijing Injection (XBJ, 血必净注射液) combined with linezolid in the treatment of severe pneumonia. Methods A comprehensive search of CNKI, Wanfang Database, VIP database, CBM database, Cochrane Library, PubMed, Web of Science and Embase databasewas conducted to collect the randomized controlled trials of XBJ combined with linezolid in the treatment of severe pneumonia from the establishment of each database to June 2022. Review Manager 5.4.1 was used to evaluate the quality of the included literature, data integration analysis and bias risk assessment were performed. Sensitivity analysis was performed with Stata14.0. Results A total of 12 randomized controlled trials were included, involving 949 patients, including 478 in the observation group and 471 in the control group. Meta-analysis results showed that the clinical total effective rate[RR=1.24, 95% CI (1.18, 1.31), P < 0.000 01] and bacterial clearance rate[RR=1.38, 95% CI (1.22, 1.55), P < 0.000 01] in the observation group were significantly higher than those in the control group. The biochemical indexes blood routine recovery time[MD=−1.38, 95% CI (−1.55, −1.20), P < 0.000 01], temperature recovery time[MD=−1.68, 95% CI (−1.92, −1.44), P < 0.000 01], sputum color change time[MD=−1.24, 95% CI (−1.42, −1.05), P < 0.000 01], lung inflammation absorption > 50% time[MD=−2.20, 95% CI (−2.66, −1.75), P < 0.000 01] in the observation group were significantly shorter than those of the control group. The maximum mid-expiratory flow[MD=0.55, 95% CI (0.51, 0.59), P < 0.000 01] and the ratio of forced expiratory volume to forced vital capacity in the first second[MD=11.66, 95% CI (10.16, 13.16), P < 0.000 01] in the observation group were significantly higher than those in the control group, while the peak expiratory flow rate[MD=−10.92, 95% CI (−14.29, −7.56), P < 0.000 01] in the observation group was significantly lower than those in the control group, with statistical significance. There was no statistical difference in adverse reactions[RR=0.99, 95% CI (0.57, 1.71), P=0.96] in the observation group compared with the control group. Conclusion XBJ combined with linezolid can promote the clinical efficacy of severe pneumonia, but the quality of the included literature is generally not high. As a consequence, more high-quality randomized controlled clinical trials are needed to evaluate the efficacy and safety of treatment outcomes.

R285.64

国家自然科学基金面上项目（81873188）；郑州大学2022年度青年教师基础研究培育基金（自然科学）（JC22862049）