目的 探討茵山蓮顆粒聯(lián)合胰酶腸溶膠囊治療慢性胰腺炎的臨床療效。方法 收集2014年7月-2015年7月在文昌市潭牛鎮(zhèn)衛(wèi)生院新橋分院接受治療的慢性胰腺炎患者86例,根據(jù)治療方案的差別將所有患者分為對(duì)照組和治療組,每組各43例。對(duì)照組餐前口服胰酶腸溶膠囊,4粒/次,3次/d。治療組在對(duì)照組治療基礎(chǔ)上口服茵山蓮顆粒,3袋/次,2次/d。兩組患者均連續(xù)治療8周。觀察兩組的臨床療效,比較治療前后兩組生活質(zhì)量評(píng)分、胃腸道癥狀改善情況,比較兩組治療前后血清淀粉酶、血清脂肪酶對(duì)氧磷酶1活性的變化情況。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為81.40%、95.35%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者自覺癥狀評(píng)分、軀體生理功能狀態(tài)評(píng)分、日常和社會(huì)活動(dòng)評(píng)分、心理情緒和狀態(tài)評(píng)分和總分均較治療前顯著提高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且與對(duì)照組比,治療組觀察指標(biāo)的改善程度更顯著,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者腹瀉、惡心、嘔吐、胃腸脹氣、消化不良和再發(fā)疼痛例數(shù)均顯著減少,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且與對(duì)照組比較,治療組減少的程度更顯著,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者淀粉酶、脂肪酶活性均顯著降低,對(duì)氧磷酶1活性升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且與對(duì)照組比較,治療組這些指標(biāo)的改善程度更顯著,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 茵山蓮顆粒聯(lián)合胰酶腸溶膠囊治療慢性胰腺炎療效顯著,可明顯改善患者胃腸道癥狀及生活質(zhì)量,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical effect of Yinshanlian Granules Combined with Pancreatin Enteric-coated Capsules in treatment of chronic pancreatitis. Methods Patients (86 cases) with chronic pancreatitis in Tanniu Town Hospital Xinqiao Branch in Wenchang from July 2014 to July 2015 were enrolled in this study. According to the different treatment plan, patients were divided into control and treatment groups, and each group had 43 cases. The patients in the control group were po administered with Pancreatin Enteric-coated Capsules before meals, 4 capsules/ time, three times daily. The patients in the treatment group were po administered with Yinshanlian Granules on the basis of the control group, 3 bags/ time, twice daily. The patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and scores of life quality, improvement of gastrointestinal symptoms, and activity of serum amylase (AMS), lipase (LPS) in serum, and paraoxonase (PON1) before and after treatment in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.40% and 95.35%, respectively, and there were differences between two groups (P < 0.05). After treatment, the subjective symptom score, physical function state score, daily and social activity score, psychological state and state score, and total score in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, diarrhea, nausea, vomiting, flatulence, dyspepsia and recurrent pain cases in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, activities of serum AMS, LPS in two groups were significantly decreased, but activities of PON1 were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Yinshanlian Granules Combined with Pancreatin Enteric-coated Capsules has clinical curative effect in treatment of chronic pancreatitis, can significantly improve gastrointestinal symptoms and quality of life of patients, which has a certain clinical application value.