Efficacy of Thymosin Alpha 1 Combined with Sivelestat and Ambroxol in Elderly Sepsis-Associated ARDS: A Randomized Trial

Objective: To assess the efficacy and safety of thymosin alpha 1 (Tα1) combined with sivelestat sodium and ambroxol in elderly patients with sepsis-associated acute respiratory distress syndrome (ARDS). Methods: In this single-center randomized trial, 171 elderly patients with sepsis-associated ARDS were assigned to a control group (sivelestat sodium + ambroxol, n=86) or an experimental group (same regimen + Tα1, n=85) for 7 days, both receiving high-flow nasal cannula oxygen therapy. Primary outcomes included clinical response, mortality, survival, respiratory function, and safety. Results: The experimental group showed a higher overall response rate than the control group (85.9% vs. 72.1%, P<0.05), lower 28-day mortality (17.6% vs. 27.9%, P<0.05), and higher 90-day survival (77.6% vs. 62.8%, P<0.05). Respiratory function improved significantly, with no difference in adverse event rates between groups. Conclusions: Tα1 combined with sivelestat sodium and ambroxol enhances clinical outcomes and respiratory function, reduces mortality, and demonstrates a favorable safety profile in elderly sepsis-associated ARDS patients.