目的 观察参麦注射液联合奥曲肽治疗急性胰腺炎的临床疗效。方法 选取2012年1月—2015年1月广州医科大学附属第五医院普通外科收治的急性胰腺炎患者78例,随机分为对照组和治疗组,每组各39例。对照组患者在基础治疗上静脉滴注醋酸奥曲肽注射液,0.6 mg奥曲肽加入250 mL生理盐水后以25 μg/h的滴速持续静脉泵入,1次/d。治疗组在对照组治疗基础上静脉滴注参麦注射液,100 mL/次,1次/d。两组均连续治疗10 d。观察两组的临床疗效,同时比较两组临床症状、体征改善情况及实验室相关指标的变化。结果 治疗后,对照组和治疗组的总有效率分别为87.18%、97.44%,两组比较差异有统计学意义(P <0.05)。治疗组腹痛、腹胀、压痛消失时间及排气恢复时间均显著低于对照组,两组比较差异具有统计学意义(P <0.05)。治疗后,两组患者天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转氨酶(ALT)均从治疗1 d开始下降,血尿淀粉酶、尿淀粉酶、血尿素氮(BUN)、血肌酐(Cr)、C反应蛋白(CRP)从治疗5 d开始下降,同组治疗前后差异具有统计学意义(P <0.05);且治疗组的下降程度优于对照组,两组比较差异有统计学意义(P <0.05)。治疗组中转手术治疗、平均住院时间均显著低于对照组,两组比较差异有统计学意义(P <0.05)。结论 参麦注射液联合奥曲肽治疗急性胰腺炎具有较好的临床疗效,可显著缓解患者的临床症状和体征,同时又能降低实验室相关指标,具有一定的临床应用价值。

Objective To observe the clinical effect of Shenmai Injection combined with octreotide in treatment of acute pancreatitis. Methods Patients (78 cases) with acute pancreatitis in Department of General Surgery of the Fifth Affiliated Hospital of Guangzhou Medical University from January 2012 to January 2015 were randomly divided into control and treatment groups, and each group had 39 cases. The patients in the control group wereiv administered with Octreotide Acetate Injection on the basis of foundation treatment (0.6 mg adding into 250 mL physiological saline), and they were continuous intravenous pumping with the dripping speed of 25 μg/h, once daily. The patients in the treatment group were iv administered with Shenmai Injection on the basis of the treatment group, 100 mL/time, once daily. Two groups were treated for 10 d. After treatment, the efficacy was evaluated, and the improvement of clinical symptoms and signs and the changes of laboratory related indicators in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 87.18% and 97.44%, respectively, and there was difference between two groups (P < 0.05). The disappear time of abdominal pain, abdominal distention and tenderness, and recovery time of exhaust in the treatment group were significantly lower than the control group, and there was difference between two groups (P < 0.05). After treatment, AST and ALT began to decline from the first day of the treatment, while blood amylase, urine amylase, BUN, Cr and CRP began to decline from the fifth day of the treatment, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). The number of transit operation treatment and average time of hospital stay in the treatment group were significantly lower than those in the control group, with significant differences between two groups (P < 0.05). Conclusions Shenmai Injection combined with octreotide has good clinical efficacy in treatment of acute pancreatitis, and can significantly relieve the clinical signs and symptoms, also can reduce the laboratory related indicators, which has a certain clinical application value.