目的 探討桉檸蒎腸溶軟膠囊聯(lián)合注射用拉氧頭孢鈉治療社區(qū)獲得性肺炎的臨床療效。方法 選取2018年2月-2020年2月天津市泰達(dá)醫(yī)院收治的社區(qū)獲得性肺炎患者230例，隨機(jī)分為對照組和治療組，每組各115例。對照組患者靜脈滴注注射用拉氧頭孢鈉，每次1~2 g加入生理鹽水100 mL，2~6 g/d。治療組在對照組的基礎(chǔ)上口服桉檸蒎腸溶軟膠囊，1粒/次，3次/d。兩組患者均治療14 d。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者血氧飽和度、血氧分壓指標(biāo)、二氧化碳分壓指標(biāo)、癥狀變化、中性粒細(xì)胞與淋巴細(xì)胞比值比，及丙二醛（MDA）、醛固酮（ALD）、腫瘤壞死因子-α（TNF-α）和肺表面活性蛋白A（SP-A）水平。結(jié)果 治療后，對照組和治療組臨床總有效率分別為78.26%、93.91%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者血氧飽和度和有氧分壓明顯高于治療前（P<0.05），二氧化碳分壓明顯低于治療前（P<0.05）；且治療組動(dòng)脈血?dú)庵笜?biāo)明顯好于對照組（P<0.05）。治療后，兩組患者體溫明顯好于治療前（P<0.05），咳嗽時(shí)間、白細(xì)胞計(jì)數(shù)（WBC）和中性粒細(xì)胞與淋巴細(xì)胞比值（NLR）均明顯降低（P<0.05）；且治療組患者體溫好于對照組，咳嗽時(shí)間、WBC和NLR明顯低于對照組（P<0.05）。治療后，兩組患者M(jìn)DA、ALD、TNF-α和SP-A水平均明顯降低（P<0.05），且治療組顯著低于對照組（P<0.05）。結(jié)論 桉檸蒎腸溶軟膠囊聯(lián)合注射用拉氧頭孢鈉治療社區(qū)獲得性肺炎安全、有效，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical study of Limonene and Pinene Enteric Soft Capsules combined with latamoxef sodium in treatment of community-acquired pneumonia. Methods Patients (230 cases) with community-acquired pneumonia in Tianjin TEDA Hospital from February 2018 to February 2019 were randomly divided into control and treatment groups, and each group had 115 cases. Patients in the control group were iv administered with Latamoxef Sodium for injection, 1-2 g added into normal saline 100 mL, 2-6 g/d. Patients in the treatment group were po administered with Limonene and Pinene Enteric Soft Capsules on the basis of the control group, 1 grain/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the saturation of blood oxygen, partial pressure of oxygen, partial pressure of carbon dioxide, symptom, the ratio of neutrophils to lymphocytes, and the levels of MDA, ALD, TNF-α, and SP-A in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 78.26% and 93.91%, respectively, and there were differences between two groups (P<0.05). After treatment, the saturation of blood oxygen, partial pressure of oxygen in two groups were significantly increased (P<0.05), but the partial pressure of carbon dioxide in two groups was significantly decreased (P<0.05), and the arterial blood gas levels in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the body temperature in two groups was significantly improved (P<0.05), the time of cough, WBC, and NLR were significantly decreased (P<0.05), and which in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the levels of MDA, ALD, TNF-α and SP-A in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusions Limonene and Pinene Enteric Soft Capsules combined with latamoxef sodium is safe, effect on community-acquired pneumonia, which has a certain clinical application value.

R974