目的 探討胸腺肽α1聯(lián)合氫化可的松注射液治療膿毒癥休克的臨床療效。方法 收集2014年3月-2017年3月在承德市中醫(yī)院治療的膿毒癥休克患者72例，根據(jù)用藥差別分為對照組（36例）和治療組（36例）。對照組靜脈滴注氫化可的松注射液，50 mg加入生理鹽水100 mL，1次/6 h。治療組在對照組基礎(chǔ)上皮下注射注射用胸腺肽α1，10 mg加入生理鹽水1 mL，1次/d。兩組均經(jīng)過10 d治療。評價(jià)兩組患者臨床療效，同時(shí)比較治療前后兩組患者血清學(xué)指標(biāo)和APACHEⅡ評分改善情況。結(jié)果 治療后，治療組總有效率和病死率分別為83.33%、8.82%，均分別顯著優(yōu)于對照組的61.11%、32.14%；兩組比較差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血清降鈣素原（PCT）、腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-1β（IL-1β）、TOLL樣受體4（TLR4）和Toll/IL-1受體銜接蛋白（TIRAP）水平均明顯降低，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組比對照組降低更顯著，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組APACHEⅡ評分均顯著降低，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組APACHEⅡ評分顯著低于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 胸腺肽α1聯(lián)合氫化可的松注射液治療膿毒癥休克可有效降低機(jī)體炎癥反應(yīng)和APACHEⅡ評分，臨床療效較好，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of thymosin α1 combined with hydrocortisone in treatment of septic shock. Methods Patients (72 cases) with septic shock in Chengde Hospital of TCM from March 2014 to March 2017 were divided into control (36 cases) and treatment (36 cases) groups according to different treatments. Patients in the control group were iv administered with Hydrocortisone Injection, 50 mg added into normal saline 100 mL, once every 6 h. Patients in the treatment group were subcutaneous injection administered with Thymosin α1 for injection on the basis of the control group, 10 mg added into normal saline 1 mL, once daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacy was evaluated, and the 28 d mortality rates, serological indexes and APACHEⅡ score in two groups before and after treatment were compared. Results After treatment, clinical efficacy and mortality rates in the treatment group were 83.33% and 8.82%, which were significantly better than 61.11% and 32.14% in the control group, respectively, and there were differences between two groups (P<0.05). After treatment, the PCT, TNF-α, IL-1β, TLR4, and TIRAP level in two groups were obviously decreased, and the difference was statistically significant in the same group (P<0.05). And these serological indexes in the treatment group decreased more significantly than that the control group, with significant difference between two groups (P<0.05). After treatment, the APACHEⅡ score in two groups was significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the APACHE score Ⅱ in the treatment group was obviously lower than that in the control group, with significant difference between two groups (P<0.05). Conclusion Thymosin α1 combined with hydrocortisone can effectively reduce inflammatory response and APACHEⅡ score in treatment of septic shock with good clinical efficacy, which has a certain clinical application value.