目的 研究血必凈注射液聯(lián)合鹽酸莫西沙星氯化鈉注射液治療重癥肺炎的臨床療效。方法 選取2018年9月—2019年9月在天津市北辰醫(yī)院治療的120例重癥肺炎患者，將所有患者隨機(jī)分為對照組和治療組，每組各60例。對照組患者靜脈滴注鹽酸莫西沙星氯化鈉注射液，0.4 g/次，1次/d。治療組在對照組基礎(chǔ)上靜脈滴注血必凈注射液，50 mL溶于100 mL生理鹽水，2次/d。兩組患者持續(xù)治療14 d。觀察兩組的臨床療效，比較兩組的臨床癥狀緩解時間、急性生理與慢性健康評分表（APACHE Ⅱ）評分、血氣指標(biāo)和血清炎性指標(biāo)。結(jié)果 治療后，治療組總有效率（96.67%）明顯高于對照組（81.67%）（P<0.05）。治療后，兩組患者APACHE Ⅱ評分顯著降低（P<0.05）；且治療組APACHE Ⅱ評分降低較多（P<0.05）。治療后，治療組患者咳嗽消失時間、啰音消失時間、體溫恢復(fù)正常時間、白細(xì)胞恢復(fù)正常時間顯著短于對照組（P<0.05）。治療后，兩組血氧分壓（pO₂）水平顯著上升，二氧化碳分壓（pCO₂）水平顯著下降（P<0.05），且治療組血氣指標(biāo)改善較多（P<0.05）。治療后，兩組血清超敏C反應(yīng)蛋白（hs-CRP）、降鈣素（PCT）、白細(xì)胞介素-1β（IL-1β）水平顯著降低（P<0.05）；并且治療組血清hs-CRP、PCT、IL-1β水平降低較多（P<0.05）。結(jié)論 血必凈注射液聯(lián)合鹽酸莫西沙星氯化鈉注射液治療重癥肺炎具有較好的臨床療效，能改善臨床癥狀和血氣指標(biāo)，降低血清炎性因子水平，值得在臨床上推廣應(yīng)用。

Objective To study the efficacy of Xubijing Injection combined with Moxifloxacin Hydrochloride and Sodium Chloride Injection in treatment of severe pneumonia. Methods Patients (120 cases) with severe pneumonia in Tianjin Beichen Hospital from September 2018 to September 2015 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were iv administered with Moxifloxacin Hydrochloride and Sodium Chloride Injection, 0.4 g/time, once daily. Patients in the treatment group were iv administered with Xubijing Injection on the basis of the control group, 50 mL added into normal saline 100 mL, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and clinical symptom relief time, acute physiology and chronic health evaluation (APACHE) Ⅱ, blood gas index, and serum inflammatory index in two groups were compared. Results After treatment, the total effective rate of the treatment group (96.67%) was significantly higher than that of the control group (81.67%) (P<0.05). After treatment, the remission times of cough, rales, body temperature, and leukocyte in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, pO₂ in two groups were significantly increased, but pCO₂ were significantly decreased (P<0.05), and the blood gas indexes of the treatment group were significantly better than those of the control group (P<0.05). After treatment, the serum levels of hs-CRP, PCT, and IL-1β in the two groups were significantly decreased (P<0.05), and the serum levels of hs-CRP, PCT and IL-1β in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Xubijing Injection combined with Moxifloxacin Hydrochloride and Sodium Chloride Injection has clinical curative effect in treatment of severe pneumonia, can improve the clinical symptoms and blood gas index, and reduce the serum level of inflammatory factors, which is worthy of clinical application.

R974

天津市北辰區(qū)科技發(fā)展計劃項目（BCWS2014-14）