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目的:评价越婢加半夏汤加味辅助治疗重症肺炎痰热壅肺证的疗效。方法:将符合入选标准的2016年1月-2018年1月秦皇岛军工医院82例重症肺炎痰热壅肺证患者采用随机数字表法分为2组，每组41例。对照组采用西医常规疗法治疗，观察组在对照组基础上加服越婢加半夏汤加味。2组均治疗14 d。分别于治疗前后进行痰热壅肺证症状评分，采用急性生理和慢性健康状况评分Ⅱ(Acute Physiology And Chronic Health Evaluation Ⅱ, APACHEⅡ)综合评估患者的生理学指标、年龄、格拉斯评分、严重器官系统功能不全，采用临床肺部感染评分(Clinical Pulmonary Infection Score, CPIS)进行肺部感染综合评估，采用ELISA法检测血清TNF-α和IL-10水平，评价临床疗效。结果:观察组总有效率为95.1%(39/41)、对照组为75.6%(31/41)，2组比较差异有统计学意义(n χ2＝4.783，n P＝0.029)。观察组治疗后发热、咳嗽、痰壅、气促评分及总分均低于对照组(n t值分别为13.741、16.731、18.681、17.443、24.187，n P值均<0.001)；APACHEⅡ与CPIS均低于对照组(n t值分别为5.283、10.928，n P值均<0.001)。观察组治疗后血清TNF-α水平低于对照组(n t＝3.862，n P<0.01)，IL-10水平高于对照组(n t＝3.507，n P<0.01)。n 结论:越婢加半夏汤加味辅助西医常规疗法可有效降低重症肺炎痰热壅肺证患者血清TNF-α和IL-10水平，改善临床症状，提高疗效。“,”Objective:To evaluate the efficacy of auxiliary treatment of n Yuebi-Jia-Banxia Decoction on severe pneumonia with syndrome of phlegm-heat obstructing lung.n Methods:A total 82 severe pneumonia patients with syndrome of phlegm-heat obstructing lung who were admitted to Qinhuangdao Military Hospital of Hebei Province from January of 2016 to January of 2018 were randomly divided into the control group and the observation group according to the numerical table method with 41 in each group. The control group was given with western medicine routine treatment measures. On the basis of the treatment of the control group, the observation group was given with auxiliary treatment of n Yuebi-Jia-Banxia Decoction. Both groups were treated for 14 days. Symptoms scores of syndrome of phlegm-heat obstructing lung were evaluated in both groups before and after treatment. The Acute Physiology And Chronic Health Evaluation Ⅱ (APACHE Ⅱ) was used to evaluate physiological indicators, age, Grasse score, and severe organ system dysfunction, Clinical Pulmonary Infection Score (CPIS) were used for comprehensive assessment of pulmonary infection, serum levels of TNF-α and IL-10 were detected by ELISE, and the clinical efficacy was evaluated in two groups.n Results:After treatment, total effective rate was 95.1% (39/41) in the observation group and 75.6% (31/41) in the control group, and the difference between the two groups was statistically significant (n χ2=4.783, n P=0.029). After treatment, fever, cough, sputum, shortness of breath and total scores in the observation group were all significantly lower than those in the control group (n t values were 13.741, 16.731, 18.681, 17.443, and 24.187, respectively, all n Ps<0.001). APACHE Ⅱ and CPIS were significantly lower than those in the control group (n t values were 5.283, 10.928, respectively, all n Ps<0.001). After treatment, serum level of TNF-α in the observation group was significantly lower (n t=3.862, n P<0.01), while IL-10 was significantly higher (n t=3.507, n P<0.01) than those in the control group.n Conclusion:The western routine therapy and n Yuebi-Jia-Banxia Decoction can down-regulate serum levels of TNF-α and IL-10 of severe pneumonia with syndrome of phlegm-heat obstructing lung, improve symptoms, and increase the efficacy.n