双歧杆菌联合乌司他丁和奥曲肽治疗重症急性胰腺炎患者的疗效  

Efficacy of Bifidobacterium combined with ulinastatin and octreotide in treatment of severe acute pancreatitis

作　　者：徐俊岩 程浩楠 王劲 李辉[2] 赵晓光 石书伟 张贻庆 张晨曦 Xu Jun-yan;Cheng Hao-nan;Wang Jin;Li Hui;Zhao Xiao-guang;Shi Shu-wei;Zhang Yi-qing;Zhang Chen-xi(The Third Division,Department of General Surgery,Jiaozuo People’s Hospital affiliated to Xinxiang Medical College,Jiaozuo 454000,China;Tumor Center,Jiaozuo People’s Hospital affiliated to Xinxiang Medical College,Jiaozuo 454000,China)

机构地区：[1]新乡医学院附属焦作市人民医院普外三区,焦作454000 [2]新乡医学院附属焦作市人民医院肿瘤中心,焦作454000

出　　处：《中国药物应用与监测》2025年第2期266-270,共5页Chinese Journal of Drug Application and Monitoring

基　　金：二〇二三年度河南省医学科技攻关计划项目(LHGJ20230910)。

摘　　要：目的探讨双歧杆菌四联活菌片联合乌司他丁和奥曲肽治疗重症急性胰腺炎(severe acute pancreatitis,SAP)患者的疗效。方法选取2023年1月至2024年1月于新乡医学院附属焦作市人民医院就诊的SAP患者86例,按随机数字表法均分为对照组和观察组。对照组予以乌司他丁和奥曲肽治疗,观察组在此基础上加用双歧杆菌四联活菌片。比较两组临床疗效、症状缓解时间与住院时间、治疗前后血清炎症因子[肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、白细胞介素6(IL-6)]水平、肠道黏膜屏障功能指标[D乳酸、二胺氧化酶(DAO)、内毒素(ET)]水平、胰腺功能指标[淀粉酶(AMY)、脂肪酶(LIPA)、胰岛素(INS)水平]以及不良反应发生情况。结果观察组总有效率为93.02%(40/43),高于对照组的76.74%(33/43)(χ^(2)=4.440,P<0.05);观察组腹胀、腹痛、呕吐症状缓解时间和住院时间[分别为(3.96±0.83)d、(3.79±0.91)d、(2.89±0.71)d、(6.83±2.04)d]均短于对照组[分别为(4.87±1.19)d、(4.62±1.12)d、(3.54±0.83)d、(12.87±4.18)d](t=4.113、3.772、3.902、8.515,均P<0.05);治疗后,两组TNF-α、IL-6、CRP水平均较治疗前下降,且观察组[分别为(35.42±10.37)μg·L^(-1)、(82.43±25.05)ng·L^(-1)、(21.87±5.72)mg·L^(-1)]均低于对照组[分别为(57.87±17.68)μg·L^(-1)、(118.47±35.18)ng·L^(-1)、(37.61±7.18)mg·L^(-1)](t=7.182、5.472、11.243,均P<0.05);治疗后,两组D乳酸、DAO、ET水平均较治疗前下降,且观察组[分别为(5.82±0.71)μg·L^(-1)、(2.27±0.45)U·mL^(-1)、(0.17±0.05)EU·mL^(-1)]均低于对照组[分别为(8.67±1.28)μg·L^(-1)、(3.83±0.76)U·mL^(-1)、(0.26±0.08)EU·mL^(-1)](t=12.768、11.582、6.256,均P<0.05);治疗后,两组AMY、LIPA水平均较治疗前下降,INS水平均较治疗前上升,且观察组AMY、LIPA水平[分别为(65.52±5.34)U·L^(-1)、(6.57±1.75)U·L^(-1)]均低于对照组[分别为(87.41±7.58)U·L^(-1)、(8.83±1.96)U·L^(-1)],INS水平[(6.75±0.82)mU·L^(-1)]高于Objective To explore the efficacy of bifidobacterium quadruple viable bacteria tablets combined with ulinastatin and octreotide in the treatment of severe acute pancreatitis(SAP).Methods A total of 86 patients with SAP admitted to Jiaozuo People's Hospital affiliated to Xinxiang Medical College from January 2023 to January 2024 were selected and divided into the control group and observation group by random number table method.The patients in the control group received ulinastatin and octreotide,whereas those in the observation group additionally received bifidobacterium quadruple viable bacteria tablets.The clinical efficacy,symptom remission time and hospitalization time,serum inflammatory factor(tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6))levels,intestinal mucosal barrier function indicator(D-lactic acid,diamine oxidase(DAO),endotoxin(ET))levels,pancreatic function indicator(amylase(AMY),lipase(LIPA),insulin(INS))levels before and after treatment and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate was 93.02%(40/43)in the observation group,which was higher than 76.74%of the control group(33/43)(χ^(2)=4.440,P<0.05).The symptom of bloating,abdominal pain,and vomiting remission time and hospitalization time of the observation((3.96±0.83)d,(3.79±0.91)d,(2.89±0.71)d,(6.83±2.04)d)were shorter than those of the control((4.87±1.19)d,(4.62±1.12)d,(3.54±0.83)d,(12.87±4.18)d)(t=4.113,3.772,3.902,8.515,all P<0.05).After treatment,the levels of TNF-α,IL-6,and CRP in both groups decreased,and they were lower in the observation group ((35.42±10.37) μg·L^(-1), (82.43±25.05) ng·L^(-1), (21.87±5.72) mg·L^(-1)) than in the control ((57.87±17.68) μg·L^(-1), (118.47±35.18) ng·L^(-1), (37.61±7.18) mg·L^(-1)) (t=7.182, 5.472, 11.243, all P<0.05). The levels of D-lactic acid, DAO, and ET in both groups decreased, and they were lower in the observation group ((5.82±0.71) μg·L^(-1), (2.27±0.45) U·mL^(-1), (0.17±0.05)

关 键 词：重症急性胰腺炎 双歧杆菌四联活菌 乌司他丁 奥曲肽 疗效 

分 类 号：R576[医药卫生—消化系统]