目的 分析清胰利胆丸联合丙氨酰谷氨酰胺注射液治疗老年重症急性胰腺炎患者的临床效果。方法 选取2019年5月—2022年5月宁国市人民医院收治的82例老年重症急性胰腺炎患者，按照随机数字表法分为对照组和治疗组，每组各41例。对照组静脉滴注丙氨酰谷氨酰胺注射液，20 g/次加入以500 mL葡萄糖溶液，1次/d。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。观察两组患者临床疗效，比较治疗前后两组患者腹痛消失和血清淀粉酶恢复正常时间，中医证候积分，及血清热休克蛋白70（HSP70）、高迁移率族蛋白1（HMGB1）、内毒素、二胺氧化酶（DAO）和D-乳酸水平。结果 治疗后，治疗组总有效率（92.68%）显著高于对照组（75.61%，P＜0.05）。治疗后，治疗组腹痛消失时间、血清淀粉酶恢复正常时间明显较对照组短（P＜0.05）。治疗后，两组中医证候积分均明显低于治疗前（P＜0.05），且治疗组低于对照组（P＜0.05）。治疗后，两组血清HSP70、HMGB1、内毒素、DAO和D-乳酸水平均明显低于治疗前，且治疗组明显低于对照组（P＜0.05）。结论 清胰利胆丸联合丙氨酰谷氨酰胺注射液治疗老年重症急性胰腺炎患者效果确切，可抑制炎症反应，调节免疫状态，促进肠道屏障功能恢复，加快临床症状缓解。

Objective To analyze the effect of Qingyi Lidan Pills combined with Alanyl Glutamine Injection in treatment of senile severe acute pancreatitis. Methods Patient (82 cases) with severe acute pancreatitis in Ningguo People's Hospital from May 2019 to May 2022 were divided into control and treatment group according to the random number table method, and each group had 41 cases. Patient in the control group was iv administered with Alanyl Glutamine Injection, 20 g/time added into glucose solution 500 mL, once daily. Patient in the treatment group were po administered with Qingyi Lidan Pills on the basis of the control group, 1 bag/time, three times daily. Patient in two groups were treated for 10 d. After treatment, the clinical evaluation was evaluated, and the disappearance time of abdominal pain and recovery time of serum amylase, TCM syndrome scores, the levels of serum HSP70, HMGB1, endotoxin, DAO and D-lactic acid in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (92.68%) was significantly higher than that of the control group (75.61%, P < 0.05). After treatment, the disappearance time of abdominal pain and the recovery time of serum amylase in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the TCM syndrome scores in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group was lower than that of the control group (P < 0.05). After treatment, the levels of serum HSP70, HMGB1, endotoxin, DAO and D-lactic acid in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The effect of Qingyi Lidan Pills combined with Alanyl Glutamine Injection in treatment of senile severe acute pancreatitis is accurate, which can inhibit the inflammatory reaction, regulate the immune state, promote the recovery of intestinal barrier function, and accelerate the relief of clinical symptoms.

R975