目的 探討雙歧桿菌四聯(lián)活菌片聯(lián)合注射用烏司他丁治療急性胰腺炎的臨床療效。方法 選取2014年6月—2017年6月在駐馬店市中心醫(yī)院消化內(nèi)科進行治療的急性胰腺炎患者206例為研究對象，根據(jù)用藥的差別將入組患者分為對照組和治療組，每組各103例。對照組靜脈滴注注射用烏司他丁，20萬單位加入到5%葡萄糖注射液250 mL中，1次/d。治療組在對照組基礎(chǔ)上給予雙歧桿菌四聯(lián)活菌片，1.5 g進行水化后自胃管灌注，夾管2 h，3次/d。兩組患者均連續(xù)治療7 d。觀察兩組的臨床療效，比較兩組的臨床癥狀恢復(fù)時間、血清因子水平、急性生理與慢性健康評分（APACHEⅡ評分）和生活質(zhì)量調(diào)查表（SF-36）評分。結(jié)果 治療后，對照組和治療組的總有效率分別為84.47%、98.06%，兩組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。治療后，治療組腹痛、腹脹、腹膜刺激征恢復(fù)時間均短于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。治療后，兩組血清C反應(yīng)蛋白（CRP）、降鈣素（PCT）、可溶性細(xì)胞黏附因子-1（sICAM-1）、白細(xì)胞介素-1β（IL-1β）、腫瘤壞死因子-α（TNF-α）水平均顯著降低，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P < 0.05）；且治療組這些觀察指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。治療后，兩組血淀粉酶（BAMY）、尿淀粉酶（UAMY）水平均顯著降低，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P < 0.05）；且治療組這些觀察指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。治療后，兩組APACHEⅡ評分顯著下降，SF-36評分明顯升高，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P < 0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。結(jié)論 雙歧桿菌四聯(lián)活菌片聯(lián)合注射用烏司他丁治療急性胰腺炎具有較好的臨床療效，可改善臨床癥狀，降低炎癥水平，改善生存質(zhì)量，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of Combined Bifidobacterium, Lactobacillus, Enterococcus and Bacillus Cereus Tablets combined with Ulinastatin for injection in treatment of acute pancreatitis. Methods Patients (206 cases) with acute pancreatitis in Zhumadian Central Hospital from June 2014 to June 2017 were randomly divided into control and treatment groups, and each group had 103 cases. Patients in the control group were iv administered with Ulinastatin for injection, 200 000 unit added into 5% glucose solution 250 mL, once daily. Patients in the treatment group were given Combined Bifidobacterium, Lactobacillus, Enterococcus and Bacillus Cereus Tablets on the basis of the control group, 1.5 g affused by gastric tube after hydration, clipped tube for 2 h, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and the recovery time of clinical symptoms, the level of serum factors, APACHE Ⅱ score, and SF-36 score in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 84.47% and 98.06%, respectively, and there was difference between two groups (P < 0.05). After treatment, the recovery time of abdominal pain, abdominal distention and peritoneum irritation sign in the treatment group were shorter than those in the control group, and there was difference between two groups (P < 0.05). After treatment, the levels of CRP, PCT, sICAM-1, IL-1β, and TNF-α in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And 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, the levels of BAMY and UAMY in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And 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, the APACHE Ⅱ score in two groups were significantly decreased, but the SF-36 score in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And 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 Combined Bifidobacterium, Lactobacillus, Enterococcus and Bacillus Cereus Tablets combined with Ulinastatin for injection has clinical curative effect in treatment of acute pancreatitis, can improve clinical symptoms, decrease inflammation level, and improve quality of life, which has a certain clinical application value.