目的 探討貞芪扶正顆粒聯(lián)合注射用亞胺培南西司他丁鈉治療重癥肺炎的療效。方法 選取2024年1月—2024年12月新疆醫(yī)科大學(xué)第一附屬醫(yī)院82例重癥肺炎患者，將所有患者按隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各41例。對(duì)照組靜滴注射用亞胺培南西司他丁鈉，1 g/次，3次/d。治療組在對(duì)照組基礎(chǔ)上沖服貞芪扶正顆粒，1袋/次，2次/d。兩組患者持續(xù)治療2周。比較兩組的治療效果、癥狀消失時(shí)間、病情程度、血?dú)庵笜?biāo)、血清炎癥指標(biāo)。結(jié)果 對(duì)照組、治療組的總有效率分別為80.49%、95.12%，組間總有效率的差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療組的體溫復(fù)常時(shí)間、咳嗽消失時(shí)間、肺啰音消失時(shí)間、痰液消失時(shí)間均短于對(duì)照組（P＜0.05）。治療后，兩組的臨床肺部感染評(píng)分（CPIS）顯著降低（P＜0.05），且治療組的CPIS明顯低于對(duì)照組（P＜0.05）。兩組治療后的氧合指數(shù)高于治療前，二氧化碳分壓低于治療前（P＜0.05）；治療組治療后的氧合指數(shù)高于對(duì)照組，二氧化碳分壓低于對(duì)照組（P＜0.05）。兩組治療后的可溶性細(xì)胞黏附分子（sICAM-1）、白細(xì)胞介素-23（IL-23）、CD64顯著降低（P＜0.05）；與對(duì)照組治療后比較，治療組治療后的sICAM-1、IL-23、CD64更低（P＜0.05）。結(jié)論 重癥肺炎患者經(jīng)貞芪扶正顆粒聯(lián)合注射用亞胺培南西司他丁鈉治療，可提高臨床療效，減輕病情，調(diào)節(jié)血?dú)庵笜?biāo)，降低炎癥反應(yīng)。

Objective To investigate the efficacy of Zhenqi Fuzheng Granules combined with Imipenem and Cilastatin Sodium for injection in treatment of severe pneumonia. Methods 82 Severe pneumonia patients from the First Affiliated Hospital of Xinjiang Medical University from January 2024 to December 2024 were select, and all patients were divide into control group and treatment group using the random number table method, with 41 patients in each group. The control group received intravenous infusion of Imipenem and Cilastatin Sodium for injection, 1 g/time, 3 times daily. On the basis of the control group, patients in the treatment group were given Zhenqi Fuzheng Granules orally with one bag each time, twice daily. Two groups completed continuous treatment for 2 weeks. The treatment efficacy, symptom disappearance time, severity of illness, blood gas indicators, and serum inflammation indicators were compared between two groups. Results The total effective rates of the control group and the treatment group were 80.49% and 95.12%, respectively, and the difference in total effective rates was statistically significant between two groups (P < 0.05). The recovery time of body temperature, disappearance time of cough, disappearance time of lung rales, and disappearance time of sputum in the treatment group were all shorter than those in the control group (P < 0.05). After treatment, the Clinical Pulmonary Infection Score (CPIS) in both groups significantly decreased (P < 0.05), and the CPIS of the treatment group was significantly lower than that of the control group (P < 0.05). The oxygenation index of both groups after treatment was higher than those before treatment, but the partial pressure of carbon dioxide was lower than those before treatment (P < 0.05). The oxygenation index of the treatment group was higher than that of the control group after treatment, but the partial pressure of carbon dioxide was lower than that of the control group (P < 0.05). After treatment, soluble cell adhesion molecule-1 (sICAM-1), interleukin-23 (IL-23), and CD64 were significantly reduced in two groups (P < 0.05), and the treatment group had lower levels of sICAM-1, IL-23, and CD64 compared with the control group after treatment (P < 0.05). Conclusion The combination of Zhenqi Fuzheng Granules and Imipenem and Cilastatin Sodium for injection in treatment of severe pneumonia can improve clinical efficacy, alleviate symptoms, regulate blood gas indicators, and reduce inflammatory reactions.

R974

新疆醫(yī)科大學(xué)第一附屬醫(yī)院“青年科研起航”專項(xiàng)基金資助項(xiàng)目（2022YFY-QKQN-95）