目的 考察熱毒寧注射液聯(lián)合注射用亞胺培南西司他丁鈉治療重癥肺炎的臨床療效。方法 選擇2020年7月—2023年2月在南京市中西醫(yī)結合醫(yī)院就診的94例重癥肺炎患者作為研究對象，參考隨機數(shù)字表法將94例患者分為對照組（n＝47）和治療組（n＝47）。對照組靜脈滴注注射用亞胺培南西司他丁鈉，1.0 g加入100 mL生理鹽水中，1次/12 h。治療組在對照組治療的基礎上靜脈滴注熱毒寧注射液，20 mL熱毒寧注射液加入250 mL葡萄糖溶液中，滴速30～60滴/min，1次/d。兩組連續(xù)治療10 d。對比兩組患者臨床療效、病情嚴重程度、癥狀消失時間、肺通氣功能、血清指標。結果 治療后，治療組總有效率與對照組的總有效率組間比較差異顯著（P＜0.05）。治療后，兩組的序貫性臟器功能衰竭（SOFA）評分顯著減少（P＜0.05），治療組的SOFA評分小于對照組（P＜0.05）。治療后，治療組高熱、咳嗽、喘息、肺啰音消失時間明顯短于對照組（P＜0.05）。治療后，兩組的氣道阻力、吸氣峰壓、平均氣道壓顯著降低（P＜0.05），治療組氣道阻力、吸氣峰壓、平均氣道壓明顯低于對照組（P＜0.05）。治療后，兩組的血清高遷移率族蛋白B1（HMGB1）、白細胞介素-18（IL-18）、可溶性髓系細胞觸發(fā)受體-1（sTREM-1）水平均顯著降低（P＜0.05），治療組的血清HMGB1、IL-18、sTREM-1水平明顯低于對照組（P＜0.05）。結論 熱毒寧注射液聯(lián)合注射用亞胺培南西司他丁鈉可顯著提高重癥肺炎的臨床療效，緩解患者的臨床癥狀和病情嚴重程度，改善肺通氣功能，顯著減輕炎癥反應。

Objective To investigate the clinical effect of Reduning Injection combined with Imipenem and Cilastatin Sodium for injection in treatment of severe pneumonia. Methods Patients (94 cases) with severe pneumonia in Nanjing Integrated Traditional Chinese and Western Medicine Hospital from July 2020 to February 2023 were divided into control group (n＝47) and treatment group (n＝47) according to random number table method. Patients in the control group were iv administered with Imipenem and Cilastatin Sodium for injection, 1.0 g added into 100 mL normal saline, once per 12 h. Patients in the treatment group were iv administered with Reduning Injection on the basis of the control group, 20 mL Reduning Injectioadded into glucose solution 250 mL, dropping rate 30 — 60 drops/min, once daily. Patients in two groups were treated for 10 d. The clinical efficacies, severity of the disease, symptom disappearance time, lung ventilation function, and serum factors in two groups were compared. Results After treatment, the total effective rate of the treatment group had significant differences with that of the control group (P < 0.05). After treatment, SOFA scores of two groups were significantly decreased (P < 0.05), and SOFA score of the treatment group was lower than that of the control group (P < 0.05). After treatment, the disappearance time of high fever, cough, wheezing, and lung rales in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the airway resistance, peak inspiratory pressure, and average airway pressure of two groups were significantly reduced (P < 0.05), and the airway resistance, peak inspiratory pressure, and average airway pressure of the treatment group were significantly lower than those of the control group (P < 0.05). After treatment, the serum levels of HMGB1, IL-18, and sTREM-1 in two groups were significantly reduced (P < 0.05), and the serum levels of HMGB1, IL-18, and sTREM-1 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Reduning injection combined with Imipenem and Cilastatin Sodium for injection can significantly improve the clinical efficacy of severe pneumonia, reduce clinical symptoms and severity of the disease, improve lung ventilation function, significantly reduce inflammation.

R974

南京市科技計劃項目（202110032）