目的 探討熱毒寧注射液聯(lián)合注射用哌拉西林鈉他唑巴坦鈉治療重癥肺炎臨床療效。方法 選取2019年9月—2022年4月河南省人民醫(yī)院收治的86例重癥肺炎患者，依據(jù)隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各43例。對(duì)照組靜脈滴注注射用哌拉西林鈉他唑巴坦鈉，4.5g加入100mL生理鹽水中，每12小時(shí)1次。治療組在對(duì)照組基礎(chǔ)上靜脈滴注熱毒寧注射液，20mL加入250mL生理鹽水中，1次/d。兩組患者連續(xù)治療14d。觀察兩組的臨床療效，比較兩組癥狀的消失時(shí)間、病情程度、氧合指數(shù)、血氧分壓、氧飽和度、C反應(yīng)蛋白（CRP）/白蛋白（ALB）、克拉拉細(xì)胞蛋白16（CC16）、中性粒細(xì)胞與淋巴細(xì)胞的比值（NLR）。結(jié)果 治療后，治療組的總有效率為95.35%，對(duì)照組的總有效率為81.40%，組間比較差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，治療組的體溫復(fù)常時(shí)間、咳嗽、肺啰音、肺陰影消失時(shí)間、住院時(shí)間均短于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組急性生理學(xué)與慢性健康狀況（APACHE Ⅱ）評(píng)分低于治療前（P＜0.05），且治療組的APACHE Ⅱ評(píng)分低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組的氧合指數(shù)、血氧分壓、氧飽和度高于治療前（P＜0.05），治療組氧合指數(shù)、血氧分壓、氧飽和度明顯高于對(duì)照組（P＜0.05）。治療后，兩組的CRP/ALB、CC16、NLR低于治療前（P＜0.05），治療組的CRP/ALB、CC16、NLR低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。結(jié)論 熱毒寧注射液聯(lián)合注射用哌拉西林鈉他唑巴坦鈉可提高重癥肺炎的臨床療效，改善臨床癥狀和通氣功能，降低炎癥反應(yīng)，且安全性良好。

Objective To investigate the clinical efficacy of Reduning Injection combined with Piperacillin Sodium and Tazobactam Sodium for injection in treatment of severe pneumonia. Methods Patients (86 cases) with severe pneumonia in Henan Provincial People's Hospital from September 2019 to April 2022 were divided into control and treatment groups according to random number table method, and each group had 43 cases. Patients in the control group were iv administered with Piperacillin Sodium and Tazobactam Sodium for injection, 4.5g added into normal saline 100 mL, once every 12 h. Patients in the treatment group were iv administered with Reduning Injection on the basis of the control group, 20 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and the disappearance time of symptoms, the degree of illness, the oxygenation index, blood oxygen partial pressure, and oxygen saturation, CRP/ALB, CC16 and NLR in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.35%, and that of the control group was 81.40%, and the difference was statistically significant between two groups (P<0.05). After treatment, the temperature normalization time, the disappearance time of cough, rale, lung shadow, and the hospitalization time of the treatment group were shorter than those of the control group, and the difference was statistically significant (P<0.05). After treatment, the APACHE Ⅱ of two groups was lower than that before treatment (P<0.05), and the APACHE Ⅱ score of the treatment group was lower than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the oxygenation index, blood oxygen partial pressure, and oxygen saturation of two groups were higher than those before treatment (P<0.05), and the oxygenation index, blood oxygen partial pressure and oxygen saturation of the treatment group were significantly higher than those of the control group (P<0.05). After treatment, the CRP/ALB, CC16, and NLR of the two groups were lower than those before treatment (P<0.05), and the CRP/ALB, CC16, and NLR of the treatment group were lower than those of the control group (P<0.05). Conclusion Reduening Injection combined with Piperacillin Sodium and Tazobactam Sodium for injection has clinical curative effect in treatment of severe pneumonia, improve clinical symptoms and ventilation function, reduce inflammatory reaction, with good safety.

R974

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（201702228）