目的 分析清胰利膽丸聯(lián)合丙氨酰谷氨酰胺注射液治療老年重癥急性胰腺炎患者的臨床效果。方法 選取2019年5月—2022年5月寧國市人民醫(yī)院收治的82例老年重癥急性胰腺炎患者，按照隨機(jī)數(shù)字表法分為對照組和治療組，每組各41例。對照組靜脈滴注丙氨酰谷氨酰胺注射液，20 g/次加入以500 mL葡萄糖溶液，1次/d。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。觀察兩組患者臨床療效，比較治療前后兩組患者腹痛消失和血清淀粉酶恢復(fù)正常時(shí)間，中醫(yī)證候積分，及血清熱休克蛋白70（HSP70）、高遷移率族蛋白1（HMGB1）、內(nèi)毒素、二胺氧化酶（DAO）和D-乳酸水平。結(jié)果 治療后，治療組總有效率（92.68%）顯著高于對照組（75.61%，P＜0.05）。治療后，治療組腹痛消失時(shí)間、血清淀粉酶恢復(fù)正常時(shí)間明顯較對照組短（P＜0.05）。治療后，兩組中醫(yī)證候積分均明顯低于治療前（P＜0.05），且治療組低于對照組（P＜0.05）。治療后，兩組血清HSP70、HMGB1、內(nèi)毒素、DAO和D-乳酸水平均明顯低于治療前，且治療組明顯低于對照組（P＜0.05）。結(jié)論 清胰利膽丸聯(lián)合丙氨酰谷氨酰胺注射液治療老年重癥急性胰腺炎患者效果確切，可抑制炎癥反應(yīng)，調(diào)節(jié)免疫狀態(tài)，促進(jìn)腸道屏障功能恢復(fù)，加快臨床癥狀緩解。

Objective To analyze the effect of Qingyi Lidan Pills combined with Alanyl Glutamine Injection in treatment of senile severe acute pancreatitis. Methods Patient (82 cases) with severe acute pancreatitis in Ningguo People's Hospital from May 2019 to May 2022 were divided into control and treatment group according to the random number table method, and each group had 41 cases. Patient in the control group was iv administered with Alanyl Glutamine Injection, 20 g/time added into glucose solution 500 mL, once daily. Patient in the treatment group were po administered with Qingyi Lidan Pills on the basis of the control group, 1 bag/time, three times daily. Patient in two groups were treated for 10 d. After treatment, the clinical evaluation was evaluated, and the disappearance time of abdominal pain and recovery time of serum amylase, TCM syndrome scores, the levels of serum HSP70, HMGB1, endotoxin, DAO and D-lactic acid in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (92.68%) was significantly higher than that of the control group (75.61%, P < 0.05). After treatment, the disappearance time of abdominal pain and the recovery time of serum amylase in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the TCM syndrome scores in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group was lower than that of the control group (P < 0.05). After treatment, the levels of serum HSP70, HMGB1, endotoxin, DAO and D-lactic acid in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The effect of Qingyi Lidan Pills combined with Alanyl Glutamine Injection in treatment of senile severe acute pancreatitis is accurate, which can inhibit the inflammatory reaction, regulate the immune state, promote the recovery of intestinal barrier function, and accelerate the relief of clinical symptoms.

R975