乳果糖灌肠联合生长抑素治疗急性胰腺炎疗效及对患者炎性因子和肠黏膜屏障功能的影响  

Lactulose enema in combination with somatostatin for treatment of acute pancreatitis:Curative efficacy and effects on inflammatory factors and intestinal mucosal barrier function

作　　者：张洪芳[1] 王学红[1] 王芳[1] 

机构地区：[1]青海大学附属医院消化内科,青海省西宁市830011

出　　处：《世界华人消化杂志》2015年第15期2475-2479,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨乳果糖灌肠联合生长抑素治疗急性胰腺炎(acute pancreatitis,AP)疗效及对患者炎性因子和肠黏膜屏障功能的影响.方法:78例符合纳入标准的AP患者按照随机数字表法随机分为对照组(n=39)和观察组(n=39).常规治疗基础中,对照组给予生长抑素治疗,观察组在对照组的基础上联合应用乳果糖灌肠治疗.观察比较两组患者临床疗效、临床指标改善时间、炎性因子水平及肠黏膜屏障功能.结果:观察组的治疗总有效率为94.9%,明显高于对照组79.5%的总有效率(P<0.05).与对照组相比,观察组腹痛缓解时间、腹胀缓解时间、禁食时间及血清淀粉酶恢复正常时间显著缩短,炎性因子肿瘤坏死因子(tumor necrosis factorα,TNF-α)、白介素6(interleukin 6,IL-6)、高灵敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平及反映肠黏膜屏障功能指标降钙素原、D-乳酸水平显著降低,比较都有统计学差异(均P<0.05).结论:乳果糖灌肠联合生长抑素治疗AP疗效可靠,能够显著提高临床疗效,缩短临床指标改善时间,减轻机体炎性反应,保护肠黏膜屏障功能,临床上值得进一步研究.AIM：To investigate the clinical effects of lactulose enema in combination with somatostatin in the treatment of acute pancreatitis（AP） and the effects on inflammatory factors and intestinal mucosal barrier function.METHODS：Seventy-eight AP patients were randomly divided into two groups equally：a control group and an observation group.Besides conventional treatments,the control group was given somatostatin alone,while the observation group was given lactulose enema in combination with somatostatin.The curative efficacy,time to improvement of clinical indices,levels of inflammatory factors and intestinal mucosal barrier function were compared for the two groups.RESULTS：The observation group had an overall effective rate of 94.9%,which was statistically higher than 79.5%in the control group（P 〈 0.05）.In comparison with the control group after treatment,the observation group had statistically shorter time to abdominal pain relief,abdominal distention relief,fasting time and time to normalization of serum amylase（P 〈 0.05 for all）.As to inflammatory factors and intestinal mucosal barrier function,levels of tumor necrosis factor α（TNF-α）,interleukin-6（IL-6）,hypersensitive C-reactive protein（hs-CRP）and indices reflecting intestinal mucosal barrier function including procalcitonin and D-lactate in the observation group were statistically lower than those in the control group（P 〈 0.05 for all）.CONCLUSION：Combined treatment of lactulose enema and somatostatin is effective for AP,which can significantly increase curative efficacy,shorten the time to improvement of clinical indices,alleviate inflammatory reaction and protect intestinal mucosal barrier function.

关 键 词：乳果糖 灌肠 生长抑素 急性胰腺炎 炎性因子 肠黏膜屏障功能 

分 类 号：R576[医药卫生—消化系统]