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Clinical Observation of Different Doses of Xuebijing Injection Combined with Ulinastatin Injection in the
Treatment of Sepsis Complicated with Acute Lung Injury
2
1
LI Lehui ，YANG Yuanzheng ，LIN Run ，HONG Liming（1. Emergency Department，the First Affiliated Hospital
1
1
of Hainan Medical College，Haikou 570102，China；2. Dept. of Critical Medicine，the First Affiliated Hospital
of Hainan Medical College，Haikou 570102，China）
ABSTRACT OBJECTIVE：To compare clinical effect and safety of different doses of Xuebijing injection combined with
Ulinastatin injection in the treatment of sepsis complicated with acute lung injury （ALI）. METHODS：Totally 115 patients
diagnosed as sepsis complicated with ALI were collected from Jul. 2015 to Nov. 2019 in intensive care unit of our hospital.
According to therapy method，the patients were divided into control group（26 cases），low-dose group（29 cases），medium-dose
group（30 cases），high-dose group（30 cases）. The control group received Ulinastatin injection 300 thousands u intravenously，q8 h，
for consecutive 5 days，on the basis of routine treatment. On the basis of control group，low-dose group additionally received
intravenous drip of Xuebijing injection 50 mL，bid，for consecutive 7 days；medium-dose group additionally received intravenous
drip of Xuebijing injection 100 mL，bid，for consecutive 7 days；high-dose group additionally received intravenous drip of
Xuebijing injection 100 mL，qid，for consecutive 7 days. The serum inflammatory factors （IL-6，TNF-α ，CRP），respiratory
function indexes（PaO2，PaO2/FiO2，ELWI）and related scores（APACEⅡ score and SOFA score）were compared among 4 groups
before and after treatment，and mechanical ventilation time，ICU hospitalization time，28-day mortality rate and adverse reactions
during the treatment were recorded. RESULTS：Before treatment，there was no statistical significance in serum inflammatory
factors，respiratory function indexes or related scores among 4 groups（P＞0.05）. After treatment，serum inflammatory factors，
ELWI and related scores of 4 groups were decreased significantly；the low-dose，medium-dose and high-dose groups were
significantly lower than the control group；the high-dose group was significantly lower than the low-dose and medium-dose groups
（P＜0.05）. PaO2 and PaO2/FiO2 of 4 groups were increased significantly， compared with before treatment； the low-dose，
medium-dose and high-dose groups were significantly higher than the control group；the high-dose group was significantly higher
than the low-dose and medium-dose groups （P＜0.05）. The mechanical ventilation time and ICU hospitalization time in the
low-dose，medium-dose and high-dose groups were significantly shorter than control group（P＜0.05），but there was no statistical
significance in above indexes among different doses groups（P＞0.05）. There was no statistical significance in 28-day mortality
among 4 groups（P＞0.05），and no serious adverse reactions were found. CONCLUSIONS：Different doses of Xuebijing injection
combined with Ulinastatin injection could effectively decrease the level of serum inflammatory factors in patients with sepsis
complicated with ALI，improve lung function and relieve the degree of organ failure；after combined with high-dose Xuebijing
injection，the therapeutic effect is more obvious and does not affect the treatment safety.
KEYWORDS Xuebijing injection；Ulinastatin；Sepsis；Acute lung injury；Doses；Therapeutic efficacy；Safety

脓毒症为重症监护病房（ICU）患者常见的致死原因 应用于脓毒症等疾病的临床治疗，然而针对脓毒症合并
[7]
之一，可导致患者多器官功能障碍。全球每年约新发脓 ALI患者，血必净注射液的使用剂量尚存一定的争议 。
[1]
毒症患者 1 800 万，且以每年 1.5％的速度不断增加 。 为此，本研究初步比较了不同剂量血必净注射液联合乌
急性肺损伤（Acute lung injury，ALI）是各种致病因素引 司他丁注射液治疗脓毒症合并ALI的效果和安全性，旨
发的急性、进行性、缺氧性呼吸衰竭，以非心源性肺水肿 在为此类疾病的临床治疗提供参考。
及顽固性低氧血症为主要特征 [2-3] 。肺是脓毒症最易累 1 资料与方法
及的器官之一，约有 40％的脓毒症患者合并有 ALI，而 1.1 纳入与排除标准
由重症肺炎、脓毒症引发的急性呼吸窘迫综合征（Acute 纳入标准：（1）符合美国危重病医学会制定的脓毒
respiratory distress syndrome，ARDS）的 病 死 率 高 达 症诊断标准 ；（2）符合中华医学会呼吸病学分会制定的
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40％～50％ 。近年来，脓毒症合并 ALI 的治疗已取得 《急性肺损伤/急性呼吸窘迫综合征的诊断标准（草案）》
[4]
显著进展，但其致死率仍居高不下 。血必净注射液作 中的ALI诊断标准 ；（3）年龄＞18岁；（4）行机械通气治
[4]
[9]
为一种中药复方注射液，由红花、川芎、赤芍、丹参、当归 疗；（5）生存时间超过 1 周。排除标准：（1）合并肺部肿
等配伍而成，具化瘀解毒之功效 ；乌司他丁注射液作 瘤、造血系统疾病、特发性肺纤维化等疾病者；（2）合并
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为一种尿胰蛋白酶抑制剂，具有调节炎症因子水平、减 自身免疫性疾病或免疫缺陷者；（3）血必净注射液、乌司
轻炎症反应和组织损伤、改善微循环和组织灌注等作 他丁等药物严重过敏而无法配合研究者；（4）近3个月应
用 。目前，血必净注射液和乌司他丁注射液已被广泛 用糖皮质激素或免疫抑制剂者；（5）依从性差者；（6）治
[6]

·1618 · China Pharmacy 2020 Vol. 31 No. 13 中国药房 2020年第31卷第13期