目的 探讨清胰利胆颗粒联合乌司他丁和生长抑素治疗急性重症胰腺炎的临床疗效。方法 选取2015年3月-2016年3月在海南医学院附属医院接受治疗的急性胰腺炎患者88例，根据治疗方案的差别分为对照组和治疗组，每组各44例。对照组给予注射用乌司他丁，10万U微量泵24 h持续输入；同时给予注射用生长抑素，6 mg/d，微量泵24 h持续输入。治疗组在对照组基础上口服清胰利胆颗粒，1袋/次，3次/d。两组患者均治疗7 d。观察两组患者的临床疗效，比较两组的临床症状消失时间、炎性因子、淀粉酶（AMS）、脂肪酶（LPS）和对氧磷酶1（PON1）的变化。结果 治疗后，对照组和治疗组的总有效率分别为81.82%、95.45%，两组比较差异有统计学意义（P<0.05）。治疗后，治疗组腹胀、腹痛、恶心呕吐及腹膜刺激征消失时间明显短于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者血清肿瘤坏死因子α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）的水平均显著降低，而白细胞介素-10（IL-10）的水平明显升高，同组治疗前后差异有统计学意义（P<0.05）；且治疗组这些观察指标的改善程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者AMS和LPS水平显著降低，而PON1水平明显升高，同组治疗前后差异有统计学意义（P<0.05）；且治疗组这些观察指标的改善程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 清胰利胆颗粒联合乌司他丁和生长抑素治疗急性重症胰腺炎疗效显著，可明显改善患者临床症状，降低血清炎性因子水平，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Qingyi Lidan Granula combined with ulinastatin and somatostatin in treatment of severe acute pancreatitis. Methods Patients (88 cases) with severe acute pancreatitis in the Affiliated Hospital of Hainan Medical University from March 2015 to March 2016 were enrolled in this study. According to the different treatment plans, patients were divided into the control and treatment groups, and each group had 44 cases. Patients in the control group were given Ulinastatin for injection, micro pump infusion of 100 000 U for 24 h. And patients in the control group were given Somatostatin for injection, micro pump infusion of 6 mg/d for 24 h. Patients in the treatment group were po administered with Qingyi Lidan Granula on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and the changes of clinical symptoms disappearance time, inflammatory factors, AMS, LPS, and PON1 in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.82% and 95.45%, respectively, and there was difference between two groups (P<0.05). After treatment, the disappearance time of abdominal distension, abdominal pain, nausea and vomiting, and peritoneal irritation in the treatment group were shorter than those in the control group (P<0.05). After treatment, the levels of TNF-α, IL-6, and IL-6 in two groups were significantly decreased, but the levels of IL-10 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And 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, the levels of AMS and LPS in two groups were significantly decreased, but the levels of PON1 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And 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 Qingyi Lidan Granula combined with ulinastatin and somatostatin has the clinical curative effect in treatment of severe acute pancreatitis, and could significantly improve clinical symptoms, reduce the level of serum inflammatory factors, which has a certain clinical application value.