目的 探讨茵山莲颗粒联合胰酶肠溶胶囊治疗慢性胰腺炎的临床疗效。方法 收集2014年7月-2015年7月在文昌市潭牛镇卫生院新桥分院接受治疗的慢性胰腺炎患者86例,根据治疗方案的差别将所有患者分为对照组和治疗组,每组各43例。对照组餐前口服胰酶肠溶胶囊,4粒/次,3次/d。治疗组在对照组治疗基础上口服茵山莲颗粒,3袋/次,2次/d。两组患者均连续治疗8周。观察两组的临床疗效,比较治疗前后两组生活质量评分、胃肠道症状改善情况,比较两组治疗前后血清淀粉酶、血清脂肪酶对氧磷酶1活性的变化情况。结果 治疗后,对照组和治疗组的总有效率分别为81.40%、95.35%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者自觉症状评分、躯体生理功能状态评分、日常和社会活动评分、心理情绪和状态评分和总分均较治疗前显著提高,同组治疗前后差异具有统计学意义(P<0.05);且与对照组比,治疗组观察指标的改善程度更显著,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者腹泻、恶心、呕吐、胃肠胀气、消化不良和再发疼痛例数均显著减少,同组治疗前后差异具有统计学意义(P<0.05);且与对照组比较,治疗组减少的程度更显著,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者淀粉酶、脂肪酶活性均显著降低,对氧磷酶1活性升高,同组治疗前后差异具有统计学意义(P<0.05);且与对照组比较,治疗组这些指标的改善程度更显著,两组比较差异有统计学意义(P<0.05)。结论 茵山莲颗粒联合胰酶肠溶胶囊治疗慢性胰腺炎疗效显著,可明显改善患者胃肠道症状及生活质量,具有一定的临床推广应用价值。

Objective To explore the clinical effect of Yinshanlian Granules Combined with Pancreatin Enteric-coated Capsules in treatment of chronic pancreatitis. Methods Patients (86 cases) with chronic pancreatitis in Tanniu Town Hospital Xinqiao Branch in Wenchang from July 2014 to July 2015 were enrolled in this study. According to the different treatment plan, patients were divided into control and treatment groups, and each group had 43 cases. The patients in the control group were po administered with Pancreatin Enteric-coated Capsules before meals, 4 capsules/ time, three times daily. The patients in the treatment group were po administered with Yinshanlian Granules on the basis of the control group, 3 bags/ time, twice daily. The patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and scores of life quality, improvement of gastrointestinal symptoms, and activity of serum amylase (AMS), lipase (LPS) in serum, and paraoxonase (PON1) before and after treatment in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.40% and 95.35%, respectively, and there were differences between two groups (P < 0.05). After treatment, the subjective symptom score, physical function state score, daily and social activity score, psychological state and state score, and total score in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, diarrhea, nausea, vomiting, flatulence, dyspepsia and recurrent pain cases in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, activities of serum AMS, LPS in two groups were significantly decreased, but activities of PON1 were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Yinshanlian Granules Combined with Pancreatin Enteric-coated Capsules has clinical curative effect in treatment of chronic pancreatitis, can significantly improve gastrointestinal symptoms and quality of life of patients, which has a certain clinical application value.