目的 探討胰膽炎合劑聯(lián)合甲磺酸加貝酯治療急性胰腺炎的臨床療效。方法 選取2019年4月—2020年8月鶴壁市人民醫(yī)院收治的96例急性胰腺炎患者，將所有患者按照隨機數(shù)字表法分為對照組和治療組，每組各48例。對照組靜脈滴注注射用甲磺酸加貝酯，前3天0.3 g/d，3 d后為0.1 g/d，加入5%葡萄糖注射液500 mL中，1次/d。治療組在對照組的基礎上口服胰膽炎合劑，20 mL/次，沖服藥粉1 g/次，2次/d。兩組患者均治療10 d。觀察兩組的臨床療效，比較兩組患者治療后癥狀改善時間，胰腺酶相關指標、血清炎性因子水平、血管活性物質指標水平。結果 治療后，治療組總有效率95.83%，顯著高于對照組的83.33%（P<0.05）。治療后，治療組患者腹脹緩解時間、腹痛緩解時間、腸鳴音恢復時間顯著短于對照組（P<0.05）。治療后，兩組血淀粉酶（S-Amy）、胰脂肪酶（LPS）均較治療前顯著降低（P<0.05）；且治療后，治療組胰腺酶相關指標低于對照組（P<0.05）。治療后，兩組單核細胞趨化蛋白（MCP-1）、可溶性髓樣細胞觸受體-1（sTREM-1）、腫瘤壞死因子-α（TNF-α）、白細胞介素-6（IL-6）水平均顯著降低（P<0.05）；且治療后治療組上述指標低于對照組（P<0.05）。治療后，兩組前列腺素（PGI2）、一氧化氮（NO）水平顯著升高，但血栓素A2（TXA2）、血管內(nèi)皮素-1（ET-1）水平顯著降低（P<0.05）；且治療后治療組血管活性物質指標改善更顯著（P<0.05）。結論 胰膽炎合劑聯(lián)合甲磺酸加貝酯治療急性胰腺炎具有良好的臨床療效，可有效改善患者臨床癥狀，抑制炎癥反應，改善胰腺微循環(huán)，值得臨床廣泛應用與推廣。

Objective To investigate the clinical study of Yidanyan Mixture combined with gabexate mesylate in treatment of acute pancreatitis. Methods A total of 96 patients with acute pancreatitis admitted to Hebi People's Hospital from April 2019 to August 2020 were selected. All the patients were divided into control group and treatment group according to random number table method, with 48 patients in each group. Patients in the control group were iv administered with Gabexate Mesylate for injection, 0.3 g/d for 3 d. After 3 d, the dosage was 0.1 g/d and added into 5% Glucose Injection 500 mL, once daily. Patients in the treatment group were po administered with Yidanyan Mixture on the basis of the control group, 20 mL/time, 1 g/time, twice daily. Patients in both groups were treated for 10 d. After treatment, the clinical efficacy was evaluated, and symptoms improvement time, pancreatic enzyme related indexes, serum inflammatory factors and vasoactive substance indexes were compared between two groups after treatment. Results After treatment, the total effective rate of the treatment group was 95.83%, which was significantly higher than that of the control group (83.33%, P<0.05). After treatment, the relief time of abdominal distension, abdominal pain, and intestinal sound recovery time in treatment group were significantly shorter than those in control group (P<0.05). After treatment, the serum amylase (S-AMY) and pancreatic lipase (LPS) in two groups was significantly decreased compared with before treatment (P<0.05). After treatment, the related indexes of pancreatic enzymes in treatment group were lower than those in control group (P<0.05). After treatment, the levels of monocyte chemotaxis protein (MCP-1), soluble myeloid cell contact receptor-1 (sRM-1), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in two groups were significantly decreased (P<0.05). After treatment, the above indexes in treatment group were lower than those in control group (P<0.05). After treatment, the levels of prostaglandin (PGI2) and nitric oxide (NO) in two groups were significantly increased, but the levels of thromboxane A2 (TXA2) and endothelin-1 (ET-1) were significantly decreased (P<0.05). After treatment, the indexes of vasoactive substances in the treatment group were improved more significantly (P<0.05). Conclusion Yidanyan Mixture combined with gabexate mesylate good clinical effect in treatment of acute pancreatitis, and can effectively improve the clinical symptoms of patients, and also can inhibit inflammation and improve pancreatic microcirculation, which is worthy of extensive clinical application and promotion.

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