目的 探討參麥注射液聯(lián)合氫化可的松注射液治療兒童膿毒癥的臨床療效。方法 選取2015年6月—2017年6月內蒙古醫(yī)科大學附屬醫(yī)院收治的膿毒癥患兒96例作為研究對象，根據(jù)入院順序將患兒隨機分為對照組和治療組，每組各48例。對照組患兒靜脈滴注氫化可的松注射液，50 mg氫化可的松注射液與0.5 g維生素C加入5%葡萄糖注射液250 mL中，1次/d。治療組在對照組治療的基礎上靜脈滴注參麥注射液，50 mL加入5%葡萄糖注射液200 mL，1次/d。兩組患兒均連續(xù)治療7 d。觀察兩組患兒臨床療效，同時比較兩組治療前后的體溫、心率、急性生理學與慢性健康狀況（APACHEⅡ）評分、血乳酸水平、24 h乳酸清除率、急診重癥監(jiān)護室（ICU）入住時長、7 d死亡率、血清學指標和免疫細胞比例。結果 治療后，對照組和治療組的總有效率分別為81.25%、93.75%，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組體溫、心率、APACHEⅡ評分、血乳酸水平均顯著降低（P<0.05）；而治療后治療組上述指標水平明顯均低于對照組（P<0.05）。治療后，治療組的24 h乳酸清除率顯著高于對照組，ICU入住時間、7 d死亡率均顯著低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組腫瘤壞死因子-α（TNF-α）、白細胞介素-6（IL-6）、白細胞介素-10（IL-10）、血清降鈣素原（PCT）、C反應蛋白（CRP）、TOLL樣受體4（TLR4）、Toll/IL-1受體銜接蛋白（TIRAP）水平均顯著降低（P<0.05）；且治療后治療組血清學指標水平均顯著低于對照組（P<0.05）。治療后，兩組CD4⁺ T細胞、NK細胞比例均顯著升高，CD8⁺ T細胞比例顯著降低，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05），且治療后治療組患者免疫細胞水平顯著優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結論 參麥注射液聯(lián)合氫化可的松注射液治療兒童膿毒癥療效顯著，可顯著降低患兒機體炎癥反應并改善患兒免疫功能，具有較好的臨床推廣應用價值。

Objective To investigate the clinical effect of Shenmai Injection combined with Hydrocortisone Injection in treatment of children's sepsis. Methods Children (96 cases) with sepsis in the Affiliated Hospital of Inner Mongolia Medical University from June 2015 to June 2017 were randomly divided into control and treatment groups according to the order of admission, and each group had 48 cases. Children in the control group were iv administered with Hydrocortisone Injection, 50 mg Hydrocortisone Injection and 0.5 g vitamin C were added into 5% glucose injection 250 mL, once daily. Children in the treatment group were iv administered with Shenmai Injection, 50 mL added into 5% glucose injection 200 mL, once daily. Children in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the body temperature, heart rate, APACHE Ⅱ score, blood lactate, ICU length of stay, 24 h lactate clearance rate, 7 d mortality rate, serological indicator levels, and immune cell levels in two groups before and after treatment were compared.Results After treatment, the clinical efficacies in the control and treatment groups were 81.25% and 93.75%, and there were differences between two groups (P<0.05). After treatment, the body temperature, heart rate, APACHE Ⅱ score, and blood lactate level were significantly decreased (P<0.05). And these indicators in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the 24 h lactate clearance rate in the treatment group were significantly higher than those in the control group, but the ICU length of stay and 7 d mortality rate in the treatment group were significantly lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, the levels of TNF-α, IL-6, IL-10, PCT, CRP, TLR4, and TIRAP were significantly decreased (P<0.05). And serological indicator levels in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, levels of CD4⁺ T and NK cells in two groups were significantly increased, but the levels of CD8⁺ T cells were decreased, and the difference was statistically significant in the same group (P<0.05). And the immune cell levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Shenmai Injection combined with Hydrocortisone Injection has significant curative effect in treatment of children's sepsis, can significantly reduce the inflammation, and improve the immune function, which has a certain clinical application value.