目的 探讨双歧杆菌四联活菌片联合注射用乌司他丁治疗急性胰腺炎的临床疗效。方法 选取2014年6月—2017年6月在驻马店市中心医院消化内科进行治疗的急性胰腺炎患者206例为研究对象，根据用药的差别将入组患者分为对照组和治疗组，每组各103例。对照组静脉滴注注射用乌司他丁，20万单位加入到5%葡萄糖注射液250 mL中，1次/d。治疗组在对照组基础上给予双歧杆菌四联活菌片，1.5 g进行水化后自胃管灌注，夹管2 h，3次/d。两组患者均连续治疗7 d。观察两组的临床疗效，比较两组的临床症状恢复时间、血清因子水平、急性生理与慢性健康评分（APACHEⅡ评分）和生活质量调查表（SF-36）评分。结果 治疗后，对照组和治疗组的总有效率分别为84.47%、98.06%，两组比较差异具有统计学意义（P < 0.05）。治疗后，治疗组腹痛、腹胀、腹膜刺激征恢复时间均短于对照组，两组比较差异具有统计学意义（P < 0.05）。治疗后，两组血清C反应蛋白（CRP）、降钙素（PCT）、可溶性细胞黏附因子-1（sICAM-1）、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）水平均显著降低，同组治疗前后比较差异具有统计学意义（P < 0.05）；且治疗组这些观察指标明显低于对照组，两组比较差异具有统计学意义（P < 0.05）。治疗后，两组血淀粉酶（BAMY）、尿淀粉酶（UAMY）水平均显著降低，同组治疗前后比较差异具有统计学意义（P < 0.05）；且治疗组这些观察指标明显低于对照组，两组比较差异具有统计学意义（P < 0.05）。治疗后，两组APACHEⅡ评分显著下降，SF-36评分明显升高，同组治疗前后比较差异具有统计学意义（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 双歧杆菌四联活菌片联合注射用乌司他丁治疗急性胰腺炎具有较好的临床疗效，可改善临床症状，降低炎症水平，改善生存质量，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Combined Bifidobacterium, Lactobacillus, Enterococcus and Bacillus Cereus Tablets combined with Ulinastatin for injection in treatment of acute pancreatitis. Methods Patients (206 cases) with acute pancreatitis in Zhumadian Central Hospital from June 2014 to June 2017 were randomly divided into control and treatment groups, and each group had 103 cases. Patients in the control group were iv administered with Ulinastatin for injection, 200 000 unit added into 5% glucose solution 250 mL, once daily. Patients in the treatment group were given Combined Bifidobacterium, Lactobacillus, Enterococcus and Bacillus Cereus Tablets on the basis of the control group, 1.5 g affused by gastric tube after hydration, clipped tube for 2 h, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and the recovery time of clinical symptoms, the level of serum factors, APACHE Ⅱ score, and SF-36 score in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 84.47% and 98.06%, respectively, and there was difference between two groups (P < 0.05). After treatment, the recovery time of abdominal pain, abdominal distention and peritoneum irritation sign in the treatment group were shorter than those in the control group, and there was difference between two groups (P < 0.05). After treatment, the levels of CRP, PCT, sICAM-1, IL-1β, and TNF-α in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And 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, the levels of BAMY and UAMY in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And 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, the APACHE Ⅱ score in two groups were significantly decreased, but the SF-36 score 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 Combined Bifidobacterium, Lactobacillus, Enterococcus and Bacillus Cereus Tablets combined with Ulinastatin for injection has clinical curative effect in treatment of acute pancreatitis, can improve clinical symptoms, decrease inflammation level, and improve quality of life, which has a certain clinical application value.