目的 探讨胰胆舒胶囊联合亚胺培南西司他丁钠治疗急性重症胰腺炎的临床疗效。方法 选取2019年3月-2020年4月在南阳市中心医院进行治疗的86例急性重症胰腺炎患者，根据就诊顺序分为对照组（43例）和治疗组（43例）。对照组静脉滴注注射用亚胺培南西司他丁钠，1.0 g/次，同0.9%氯化钠注射液100 mL配伍，每8小时1次；治疗组在对照组基础上口服胰胆舒胶囊，2 g/次，3次/d。两组均经2周治疗后进行效果对比。观察两组的临床疗效，比较两组临床症状消失时间、血清学指标、肠道屏障功能指标。结果 经治疗，对照组总有效率为81.40%，显著低于治疗组（97.67%，P<0.05）。经治疗，治疗组在口干、腹痛、恶心呕吐、痞满燥实、小便短赤等症状消失时间上均短于对照组（P<0.05）。经治疗，两组血清超敏C反应蛋白（hs-CRP）、微管相关蛋白1轻链3（MAP1-LC3）、可溶性髓系细胞触发受体-1（sTREM-1）、肿瘤坏死因子-α（TNF-α）、P物质、降钙素原（PCT）水平均较治疗前显著降低（P<0.05）；治疗后，治疗组患者血清学指标低于对照组（P<0.05）。经治疗，两组血清淀粉酶（AMS）、二胺氧化酶（DAO）、D-乳酸水平均较治疗前显著降低（P<0.05），并以治疗组降低更显著（P<0.05）。结论 胰胆舒胶囊联合注射用亚胺培南西司他丁钠治疗急性重症胰腺炎患者具有较好的疗效，可有效改善患者临床症状，降低机体炎症反应，有利于机体肠道功能的恢复，有着良好临床应用价值。

Objective To investigate the clinical efficacy of Yidanshu Capsules combined with imipenem and cilastatin sodium in treatment of acute severe pancreatitis. Methods A total of 86 patients with acute severe pancreatitis who were treated in Nanyang Central Hospital from March 2019 to April 2020 were selected and divided into control group (43 cases) and treatment group (43 cases) according to the order of treatment. Patients in the control group were iv administered with Imipenem and Cilastatin Sodium for injection, 1.0 g/time combined with 0.9% sodium chloride injection 100 mL, once every 8 h. Patients in the treatment group were po administered with Yidanshu Capsules on the basis of control group, 2 g/time, 3 times daily. The two groups were compared after two weeks of treatment. The clinical efficacy of the two groups was observed, and the time of clinical symptom disappearance, serological indexes and intestinal barrier function indexes were compared between the two groups. Results After treatment, the total effective rate of control group was 81.40%, significantly lower than that of treatment group (97.67%, P<0.05). After treatment, the disappearance time of dry mouth, abdominal pain, nausea and vomiting, fullness and dryness and short red urine in the treatment group was shorter than that in the control group (P<0.05). After treatment, the serum levels of hs-CRP, MAP1-LC3, sSM-1, TNF-α, PCT in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, the serological indexes in treatment group were lower than those in control group (P<0.05). After treatment, the levels of AMS, DAO and D-lactic acid in two groups were significantly decreased compared with before treatment (P<0.05), and the decrease was more significant in the treatment group (P<0.05). Conclusion Yidanshu Capsules combined with imipenem and cilastatin sodium has good curative effect in treatment of acute severe pancreatitis, and can effectively improve the clinical symptoms of patients, also can reduce the inflammatory response of the body, and is conducive to the recovery of intestinal function, which has good clinical application value.

R975

河南省医学科技攻关计划项目（142102310250）