目的 探讨大黄通便颗粒联合乌司他丁注射液治疗急性胰腺炎的临床疗效。方法 选取秦皇岛市第一医院于2023年1月—2024年12月收治的140例急性胰腺炎，将患者按随机数字表法分为对照组和治疗组，每组70例。对照组滴注乌司他丁注射液，2次/d，1支/次，持续滴注2 h。治疗组在对照组基础上冲服大黄通便颗粒，1袋/次，3次/d。两组持续治疗2周。评估两组患者的治疗效果、症状改善情况、病情严重程度、血清指标。结果 完成治疗，对照组的总有效率为80.00%，治疗组的总有效率为91.43%，组间比较差异显著（P＜0.05）。治疗组患者的腹痛、腹胀、肠鸣音、呕吐消失时间和自主排便时间均短于对照组（P＜0.05）。治疗后，两组的急性胰腺炎床边指数（BISAP）评分均比同组治疗前小（P＜0.05），治疗组的BISAP评分较对照组更小（P＜0.05）。治疗后，两组的血清高迁移率族蛋白B1（HMGB1）、血清淀粉样蛋白A（SAA）、S100钙结合蛋白A12（S100A12）、CXC趋化因子配体1（CXCL10）水平显著减小（P＜0.05），治疗组的血清HMGB1、SAA、S100A12、CXCL10水平均低于对照组（P＜0.05）。结论 大黄通便颗粒联合乌司他丁注射液可提高急性胰腺炎的疗效，改善临床症状，控制病情发展，减轻炎症反应。

Objective To investigate the clinical efficacy of Dahuang Tongbian Granules combined with Ulastatin Injection in treatment of acute pancreatitis. Methods 140 Cases of acute pancreatitis admitted to First Hospital of Qinhuangdao from January 2023 to December 2024 were selected and randomly divided into control group and treatment group using a random number table method, with 70 cases in each group. The control group received intravenous infusion of Ulastatin Injection, twice daily, with a dose of 1 tube per dose, continuously for 2 h. On the basis of the control group, the treatment group took Dahuang Tongbian Granules orally, 3 times daily with 1 bag each time. Both groups received continuous treatment for 2 weeks. The treatment effect, symptom improvement, severity of illness, and serum indicators of two groups were compared. Results Patients in the control group achieved a total effective rate of 80.00% after treatment, while patients in the treatment group achieved a total effective rate of 91.43%, with a significant difference between the groups (P < 0.05). The disappearance times of abdominal pain, bloating, bowel sounds, and vomiting, and spontaneous defecation time in the treatment group were shorter than those in the control group (P < 0.05). After treatment, the BISAP scores of both groups were lower than those before treatment, and the BISAP scores of the treatment group was lower than those of the control group (P < 0.05). After treatment, the levels of HMGB1, SAA, S100A12, and CXCL10 were significantly reduced in both groups (P < 0.05), and the levels of HMGB1, SAA, S100A12, and CXCL10 levels in the treatment group were all lower than those in the control group (P < 0.05). Conclusion The combination of Dahuang Tongbian Granules and Ulastatin Injection can improves the efficacy of acute pancreatitis, alleviate clinical symptoms, control disease progression, and reduces inflammatory response.

R975

秦皇岛市科学技术研究与发展计划项目（20210A080）