目的 探討清胰利膽丸聯(lián)合加貝酯治療急性胰腺炎的臨床效果。方法 選取2020年1月-2020年12月河南科技大學(xué)第一附屬醫(yī)院收治的80例急性胰腺炎患者,使用隨機數(shù)字表法將80例患者分成治療組與對照組各40例。對照組靜脈滴注注射用甲磺酸加貝酯,治療開始3 d內(nèi),0.1 g/次,3次/d,之后調(diào)整為0.1 g/次,1次/d;每次將0.1 g加入5%葡萄糖液500 mL中充分稀釋后給藥。治療組在對照組基礎(chǔ)上口服清胰利膽丸,1袋/次,3次/d。兩組均連續(xù)治療10 d。觀察兩組的臨床療效,比較治療前后兩組改良CT嚴(yán)重指數(shù)(MCTSI)評分、急性生理和慢性健康狀況評分系統(tǒng)Ⅱ(APACHEⅡ)評分及血清腫瘤壞死因子(TNF)-α、細胞間黏附分子-1(ICAM-1)、高遷移率族蛋白B1(HMGB1)、丙二醛(MDA)和超氧化物歧化酶(SOD)水平。結(jié)果 治療后,治療組總有效率是92.5%,顯著高于對照組的75.0%(P<0.05)。與對照組相比,治療組典型癥狀(腹痛、上腹壓痛)的消失時間及血清淀粉酶復(fù)常時間均顯著縮短(P<0.05)。治療后,兩組MCTSI評分和APACHEⅡ評分均顯著低于治療前(P<0.05);且均以治療組的改善更顯著(P<0.05)。治療后,兩組血清TNF-α、ICAM-1、HMGB1和MDA水平較治療前均顯著下降,血清SOD水平較治療前均顯著上升(P<0.05);且治療后,治療組血清各因子水平改善優(yōu)于對照組(P<0.05)。結(jié)論 清胰利膽丸聯(lián)合加貝酯對急性胰腺炎患者具有確切的臨床療效,可安全有效且迅速地控制患者病情,抑制體內(nèi)炎癥反應(yīng),減輕機體氧化應(yīng)激損傷。

Objective To investigate the clinical effect of Qingyi Lidan Pills combined with gabexate in treatment of acute pancreatitis.Methods A total of 80 patients with acute pancreatitis admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2020 to December 2020 were selected, and 80 patients were divided into treatment group and control group with 40 cases in each group by random number table method. Patients in the control group were iv administered with Gabexate Mesilate for injection, within 3 days of the beginning of treatment, 0.1 g/time, 3 times daily, then adjusted to 0.1 g/time, once daily, and 0.1g was added to 5% glucose solution 500 mL each time and given the drug after sufficient dilution. Patients in the treatment group were po administered with Qingyi Lidan Pills on the basis of the control group, 1 bag/time, three times daily. Both groups were treated for 10 d. The clinical efficacy of the two groups was observed. The modified CT severity index (MCTSI) score, acute physiology and chronic health status scoring system Ⅱ (APACHE Ⅱ) score, serum tumor necrosis factor (TNF)-α, intercellular adhesion molecule-1 (ICAM-1), high mobility group protein B1 (HMGB1), malondialdehyde (MDA) and superoxide dismutability (SOD) were compared before and after treatment.Results After treatment, the total effective rate in the treatment group was 92.5%, significantly higher than 75.0% in the control group (P < 0.05). Compared with the control group, the disappearance time of typical symptoms (abdominal pain, upper abdominal tenderness) and the recovery time of serum amylase in the treatment group were significantly shortened (P < 0.05). After treatment, MCTSI score and APACHE Ⅱ score in two groups were significantly lower than before (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). After treatment, the levels of TNF-α,ICAM-1, HMGB1 and MDA in serum of two groups were significantly decreased compared with before treatment, while the level of SOD in serum was significantly increased (P < 0.05). After treatment, the improvement of serum indexes in the treatment group was better than that in the control group (P < 0.05).Conclusion Qingyi Lidan Pills combined with gabexate has a definite clinical effect on patients with acute pancreatitis, and can safely, effectively and quickly control the patient's condition, inhibit the inflammatory response in the body, and reduce the body's oxidative stress damage.

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