目的 探讨清胰利胆丸联合加贝酯治疗急性胰腺炎的临床效果。方法 选取2020年1月-2020年12月河南科技大学第一附属医院收治的80例急性胰腺炎患者,使用随机数字表法将80例患者分成治疗组与对照组各40例。对照组静脉滴注注射用甲磺酸加贝酯,治疗开始3 d内,0.1 g/次,3次/d,之后调整为0.1 g/次,1次/d;每次将0.1 g加入5%葡萄糖液500 mL中充分稀释后给药。治疗组在对照组基础上口服清胰利胆丸,1袋/次,3次/d。两组均连续治疗10 d。观察两组的临床疗效,比较治疗前后两组改良CT严重指数(MCTSI)评分、急性生理和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及血清肿瘤坏死因子(TNF)-α、细胞间黏附分子-1(ICAM-1)、高迁移率族蛋白B1(HMGB1)、丙二醛(MDA)和超氧化物歧化酶(SOD)水平。结果 治疗后,治疗组总有效率是92.5%,显著高于对照组的75.0%(P<0.05)。与对照组相比,治疗组典型症状(腹痛、上腹压痛)的消失时间及血清淀粉酶复常时间均显著缩短(P<0.05)。治疗后,两组MCTSI评分和APACHEⅡ评分均显著低于治疗前(P<0.05);且均以治疗组的改善更显著(P<0.05)。治疗后,两组血清TNF-α、ICAM-1、HMGB1和MDA水平较治疗前均显著下降,血清SOD水平较治疗前均显著上升(P<0.05);且治疗后,治疗组血清各因子水平改善优于对照组(P<0.05)。结论 清胰利胆丸联合加贝酯对急性胰腺炎患者具有确切的临床疗效,可安全有效且迅速地控制患者病情,抑制体内炎症反应,减轻机体氧化应激损伤。

Objective To investigate the clinical effect of Qingyi Lidan Pills combined with gabexate in treatment of acute pancreatitis.Methods A total of 80 patients with acute pancreatitis admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2020 to December 2020 were selected, and 80 patients were divided into treatment group and control group with 40 cases in each group by random number table method. Patients in the control group were iv administered with Gabexate Mesilate for injection, within 3 days of the beginning of treatment, 0.1 g/time, 3 times daily, then adjusted to 0.1 g/time, once daily, and 0.1g was added to 5% glucose solution 500 mL each time and given the drug after sufficient dilution. Patients in the treatment group were po administered with Qingyi Lidan Pills on the basis of the control group, 1 bag/time, three times daily. Both groups were treated for 10 d. The clinical efficacy of the two groups was observed. The modified CT severity index (MCTSI) score, acute physiology and chronic health status scoring system Ⅱ (APACHE Ⅱ) score, serum tumor necrosis factor (TNF)-α, intercellular adhesion molecule-1 (ICAM-1), high mobility group protein B1 (HMGB1), malondialdehyde (MDA) and superoxide dismutability (SOD) were compared before and after treatment.Results After treatment, the total effective rate in the treatment group was 92.5%, significantly higher than 75.0% in the control group (P < 0.05). Compared with the control group, the disappearance time of typical symptoms (abdominal pain, upper abdominal tenderness) and the recovery time of serum amylase in the treatment group were significantly shortened (P < 0.05). After treatment, MCTSI score and APACHE Ⅱ score in two groups were significantly lower than before (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). After treatment, the levels of TNF-α,ICAM-1, HMGB1 and MDA in serum of two groups were significantly decreased compared with before treatment, while the level of SOD in serum was significantly increased (P < 0.05). After treatment, the improvement of serum indexes in the treatment group was better than that in the control group (P < 0.05).Conclusion Qingyi Lidan Pills combined with gabexate has a definite clinical effect on patients with acute pancreatitis, and can safely, effectively and quickly control the patient's condition, inhibit the inflammatory response in the body, and reduce the body's oxidative stress damage.

R975