胰胆炎合剂联合甲磺酸加贝酯治疗急性胰腺炎的临床研究  

Clinical study on Yidanyan Mixture combined with gabexate mesylate in treatment of acute pancreatitis

作　　者：董家山 乔磊 段志方 DONG Jia-shan;QIAO Lei;DUAN Zhi-fang(Department of General Surgery,Hebi People's Hospital,Hebi 458000,China)

机构地区：[1]鹤壁市人民医院综合外科,河南鹤壁458000

出　　处：《现代药物与临床》2021年第6期1264-1268,共5页Drugs & Clinic

摘　　要：目的探讨胰胆炎合剂联合甲磺酸加贝酯治疗急性胰腺炎的临床疗效。方法选取2019年4月—2020年8月鹤壁市人民医院收治的96例急性胰腺炎患者,将所有患者按照随机数字表法分为对照组和治疗组,每组各48例。对照组静脉滴注注射用甲磺酸加贝酯,前3天0.3 g/d,3 d后为0.1 g/d,加入5%葡萄糖注射液500 mL中,1次/d。治疗组在对照组的基础上口服胰胆炎合剂,20 m L/次,冲服药粉1 g/次,2次/d。两组患者均治疗10 d。观察两组的临床疗效,比较两组患者治疗后症状改善时间,胰腺酶相关指标、血清炎性因子水平、血管活性物质指标水平。结果治疗后,治疗组总有效率95.83%,显著高于对照组的83.33%(P<0.05)。治疗后,治疗组患者腹胀缓解时间、腹痛缓解时间、肠鸣音恢复时间显著短于对照组(P<0.05)。治疗后,两组血淀粉酶(S-Amy)、胰脂肪酶(LPS)均较治疗前显著降低(P<0.05);且治疗后,治疗组胰腺酶相关指标低于对照组(P<0.05)。治疗后,两组单核细胞趋化蛋白(MCP-1)、可溶性髓样细胞触受体-1(s TREM-1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平均显著降低(P<0.05);且治疗后治疗组上述指标低于对照组(P<0.05)。治疗后,两组前列腺素(PGI2)、一氧化氮(NO)水平显著升高,但血栓素A2(TXA2)、血管内皮素-1(ET-1)水平显著降低(P<0.05);且治疗后治疗组血管活性物质指标改善更显著(P<0.05)。结论胰胆炎合剂联合甲磺酸加贝酯治疗急性胰腺炎具有良好的临床疗效,可有效改善患者临床症状,抑制炎症反应,改善胰腺微循环,值得临床广泛应用与推广。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(s RM-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(

关 键 词：胰胆炎合剂 注射用甲磺酸加贝酯 急性胰腺炎 炎症反应 胰腺微循环 血栓素A2 血管内皮素-1 

分 类 号：R975[医药卫生—药品]