清开灵注射液联合亚胺培南西司他丁钠治疗老年重症肺炎的临床研究

目的 基于网络药理学的方法探索银翘解毒软胶囊治疗新型冠状病毒肺炎（COVID-19）的作用机制。方法 将银翘解毒软胶囊所含1 418个化合物与48个COVID-19炎症相关靶蛋白进行分子对接，构建药物-靶蛋白网络，阐明银翘解毒软胶囊的关键活性成分和潜在作用靶点。结果 通过网络分析获得银翘解毒软胶囊的活性成分有50个，主要为黄酮类和三萜类化合物；潜在作用靶点37个，主要为MTOR、JAK3、ACE、ACE2、PIK3CA、TNF、AKT2和MAP2K1等炎症靶点。分子对接结果显示连翘酯苷及牡荆素-2″-O-鼠李糖苷与新型冠状病毒（SARS-CoV-2）3CL水解酶具有较好的亲和力，甘草酸与血管紧张素转化酶II（ACE2）具有较好的亲和力。结论 银翘解毒软胶囊通过干扰SARS-CoV-2病毒复制、调节炎症信号通路表达及炎症因子分泌发挥治疗COVID-19作用。

Clinical study on Qingkailing Injection combined with imipenem and cilastatin sodium in treatment of severe pneumonia in the elderly

Objective To investigate the clinical effect of Qingkailing Injection combined with imipenem and cilastatin sodium in treatment of severe pneumonia in the elderly. Methods 62 elderly patients with severe pneumonia who were treated in Puyang Oilfield General Hospital from January 2017 to June 2020 were selected as study subjects, and they were divided into control group and treatment group according to the order of treatment, with 31 patients in each group. Patients in the control group were iv administered with Imipenem and Cilastatin Sodium for injection, 20 mL/time was compatible with 100 mL normal saline, and intravenous infusion was performed once every 8 h. Patients in the treatment group were iv administered with Qingkailing Injection on the basis of the control group, 20 mL was compatible with 100 mL normal saline, and intravenous infusion was performed once every 12 h. The effects of the two groups were compared after treatment for 10 days. The clinical efficacy of the two groups was observed, and the changes of clinical symptom recovery time, lung function indexes, blood gas analysis indexes and serological indexes in the two groups were compared. Results After treatment, the total effective rate of 96.77% in the treatment group was significantly higher than 80.65% in the control group (P<0.05). After treatment, the temperature recovery time, cough extinction time, dyspnea extinction time and lung rhonchus extinction time in the treatment group were significantly shorter than those in the control group (P<0.05). After treatment, forced expiratory volume (FEV1), forced vital capacity (FVC) and peak expiratory flow (PEF) in both groups were significantly higher than those before treatment (P<0.05). After treatment, these lung function indexes in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, oxygen partial pressure (pO₂) and oxygenation index (pO₂/FiO₂) were significantly increased in both groups, while carbon dioxide partial pressure (pCO₂) was significantly decreased in both groups (P<0.05). After treatment, the blood gas analysis indexes of the treatment group were better than those of the control group (P<0.05). After the treatment, serum hypersensitive C-reactive protein (hs-CRP), calcitonin (PCT), soluble myeloid cells trigger receptor (sTREM-1) and high mobility group protein 1 (HMGB1) in two groups was significantly reduced, but SP protein (SP-D), soluble urokinase type fibrinolytic enzyme receptor (suPAR) was significantly increased (P<0.05). After treatment, these serological indicators in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Qingkailing Injection combined with imipenem and cilastatin sodium has good clinical effect in treatment of severe pneumonia in the elderly, and can effectively improve patients'' lung function and blood gas analysis indicators, and promote the improvement of the body''s cytokine levels, which has certain clinical application value.