目的 探究胰胆舒胶囊联合乌司他丁治疗急性胰腺炎的临床效果。方法 选取2019年1月—2020年1月来武警特色医学中心和南开医院进行治疗的120例急性胰腺炎患者，随机分成对照组（n=60）和治疗组（n=60）。对照组静脉滴注注射用乌司他丁，10万U与生理盐水250 mL混合，2次/d。治疗组在对照组治疗基础上口服胰胆舒胶囊，3粒/次，3次/d。两组均连续治疗14 d。观察两组临床疗效，对两组的临床症状缓解时间、各生化指标水平和炎症因子水平进行比较。结果 治疗后，治疗组的总有效率为96.67%，显著高于对照组的75.00%（P<0.05）。治疗组体温恢复时间、排气恢复时间、血淀粉酶恢复时间、尿淀粉酶恢复时间、恶心/呕吐消失时间、腹痛消失时间、腹水消失时间均显著短于对照组（P<0.05）。治疗后两组患者总胆固醇（TC）、三酰甘油（TG）、血清淀粉酶（AMS）、血清脂肪酶（LPS）、天门冬氨酸氨基转移酶（AST）均显著降低（P<0.05）；治疗后治疗组患者各生化指标水平均低于对照组（P<0.05）。治疗后，两组的血清C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平均显著降低，但血清白细胞介素-10（IL-10）水平均升高（P<0.05）；治疗后，治疗组CRP、IL-6、TNF-α低于对照组，而IL-10高于对照组（P<0.05）。结论 胰胆舒胶囊联合乌司他丁治疗急性胰腺炎具有较好的临床疗效，能够快速缓解临床症状，改善各生化指标，缓解炎性反应，且无明显不良反应，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Yidanshu Capsules combined with ulinastatin in treatment of acute pancreatitis. Methods A total of 120 patients with acute pancreatitis who were treated in the Armed Police Special Medical Center and Nankai Hospital from January 2019 to January 2020 were randomly divided into control group (n=60) and treatment group (n=60). Patients in the control group were iv administered with Ulinastatin for injection, 100 000 U was mixed with normal saline 250 mL, twice daily. Patients in the treatment group were po administered with Yidanshu Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the remission time of clinical symptoms, the levels of biochemical indexes and inflammatory factors were compared between two groups. Results After treatment, the total effective rate of the treatment group was 96.67%, which was significantly higher than that of the control group (75.00%, P<0.05). The recovery time of body temperature, exhaust, blood amylase, urinary amylase, disappearance time of nausea/vomiting, abdominal pain and ascites in treatment group were significantly shorter than those in control group (P<0.05). After treatment, total cholesterol (TC), triglyceride (TG), serum amylase (AMS), serum lipase (LPS), and aspartate aminotransferase (AST) in two groups were significantly decreased (P<0.05). After treatment, the biochemical indexes in the treatment group were lower than those in the control group (P<0.05). After treatment, the serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in both groups were significantly decreased, but the serum levels of interleukin-10 (IL-10) were increased (P<0.05). After treatment, CRP, IL-6 and TNF-α in treatment group were lower than those in control group, while IL-10 was higher than those in control group (P<0.05). Conclusions Yidanshu Capsules combined with ulinastatin has a good clinical effect in treatment of acute pancreatitis, and can quickly alleviate clinical symptoms, improve biochemical indicators, alleviate inflammatory response, and has no obvious adverse reactions, which has a certain value of clinical application.

R975

天津市卫生和计划生育委员会科研基金资助项目（2017KZ089）