The influence of Xuebijing combined with Sivelestat sodium therapy on inflammatory response and organ function in patients with severe pneumonia

ZHANG Yingjie; ZHANG Xiaoke; LI Zhen

doi:10.3969/j.issn.1672-8521.2025.05.003

Abstract：Objective To investigate the value of Xuebijing injection combined with and Sivelestat sodium therapy on protecting inflammatory factors and organ function in patients with severe pneumonia.Methods Clinical data of 95 patients with severe pneumonia admitted to the intensive care unit(ICU)of Zhengzhou Second People's Hospital from January to June 2023 were collected.Based on whether they received treatment with Xuebijing injection and sivelestat sodium,these patients were divided into the Xuebijing group(n=51)and the combination medication group(n=44,receiving both Xuebijing injection and Sivelestat sodium).Inflammatory markers[white blood cell(WBC)count,platelet(PLT)count,C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6)]and organ function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr),urea,fibrinogen(FIB)]were compared between the two groups at baseline and at the endpoint(transfer out of ICU or death).Duration of mechanical ventilation,length of ICU stay,and mortality were also compared.Adverse reactions in both groups were recorded.Results At baseline,there was no statistical significance in serum inflammatory factors(WBC count,PLT,CRP,PCT,IL-6)and organ function indicators(ALT,AST,Cr,Urea,FIB)between the two groups(P>0.05).At the endpoint of treatment,the mean values of PCT in the Xuebijing group and the medication combination group were 0.19 ng/mL and 0.27 ng/mL respectively,which were significantly lower than baseline of 0.78 and 1.01 ng/mL(Z=-2.888 and-2.386 respectively,P<0.05).Similarly,the mean values of CRP decreased significantly to 46.20 mg/L and 59.03 mg/L from baseline of 94.53 mg/L and 98.71 mg/L(Z=-3.417 and-1.963 respectively,P<0.05).In the medication combination group,the mean IL-6 level decreased significantly from 64.0 pg/mL to 13.1 pg/mL(Z=-3.158,P<0.05),and the mean Urea level decreased from 5.89 mmol/L to 5.12 mmol/L(Z=-2.134,P<0.05).In contrast,the mean FIB level in the Xuebijing group increased significantly from 4.15 g/L to 5.95 g/L(Z=2.877,P<0.05).At the endpoint of treatment,the median levels of IL-6,Urea,and FIB in the medication combination group were significantly lower than those in the Xuebijing group[IL-6:13.1 pg/mL vs.30.5 pg/mL,Z=-1.660;Urea:5.12 mmol/L vs.5.67 mmol/L,Z=-1.732;FIB:4.39 g/L vs.5.95 g/L,Z=-2.439;P<0.05].The platelet count was significantly higher in the combination group compared to the Xuebijing group[164×10⁹/L vs.112×10⁹/L,Z=-1.885,P<0.05].Additionally,the duration of mechanical ventilation was significantly shorter in the medication combination group than in the Xuebijing group[(6.39±3.83)d vs.(7.76±2.72)d,t=-1.960,P<0.05].Conclusions Compared with Xuebijing injection alone,the combination therapy of Xuebijing injection and Sivelestat sodium significantly reduces inflammatory cytokine levels,provides greater protection to renal function and coagulation function,shortens the duration of mechanical ventilation,and demonstrates a favorable safety profile.