目的 探讨清胰利胆片联合兰索拉唑治疗急性胰腺炎的临床疗效。方法 选取2021年6月—2024年4月首都医科大学附属北京同仁医院收治的急性胰腺炎患者94例，随机分为对照组和治疗组，每组各47例。对照组静脉滴注注射用兰索拉唑，30 mg加入100 mL生理盐水，2次/d。在对照组基础上，治疗组口服清胰利胆片，6片/次，3次/d。两组患者疗程均为10 d。观察两组患者临床疗效，比较治疗前后两组患者临床恢复参数，慢性健康状况评分系统Ⅱ（APACHEⅡ）、改良CT严重指数（MCTSI）和急性胰腺炎严重程度床边指数（BISAP）评分，及血清二胺氧化酶（DAO）、肿瘤坏死因子受体相关因子6（TRAF6）、白细胞介素-1β（IL-1β）、IL-6和巨噬细胞炎性蛋白-1α（MIP-1α）水平。结果 治疗后，治疗组总有效率明显高于对照组（93.62% vs 78.72%，P＜0.05）。治疗后，治疗组各项症状（腹痛、腹胀等）及体征（肠鸣音、腹内高压）的消失时间和血淀粉酶复常时间均显著短于对照组（P＜0.05）。治疗后，两组APACHEⅡ、MCTSI和BISAP评分均低于同组治疗前（P＜0.05），且治疗组评分明显低于对照组（P＜0.05）。治疗后，两组血清DAO、TRAF6、IL-1β、IL-6和MIP-1α水平均低于组内治疗前（P＜0.05），且治疗组患者这些血清因子水平明显低于对照组（P＜0.05）。结论 清胰利胆片与兰索拉唑的协同治疗方案有良好的安全性，通过抑制全身炎症反应和修复肠黏膜屏障功能，能同步改善急性胰腺炎患者的症状、病情及整体健康状态。

Objective To investigate the clinical efficacy of Qingyi Lidan Tablets combined with lansoprazole in treatment of acute pancreatitis. Methods Patients (94 cases) with acute pancreatitis in Beijing Tongren Hospital Affiliated to Capital Medical University from June 2021 to April 2024 were randomly divided into control and treatment group, and each group had 47 cases. Patients in the control group were iv administered with Lansoprazole for injection, 30 mg was added into 100 mL normal saline, twice daily. Patients in the treatment group were po administered with Qingyi Lidan Tablets on the basis of the control group, 6 tablets/time, three times daily. Patients in two groups were treated for 10 d. After treatment, the clinical evaluations were evaluated, and the clinical recovery parameters, the APACHE II, MCTSI, and BISAP scores, and the serum DAO, TRAF6, IL-1 β, IL-6, and MIP-1α levels in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (93.62% vs 78.72%, P < 0.05). After treatment, the disappearance time of various symptoms (abdominal pain, abdominal distension, etc.) and signs (bowel sounds, intra-abdominal hypertension) and the recovery time of blood amylase in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the APACHEⅡ, MCTSI and BISAP scores in two groups were lower than those in the same group before treatment (P < 0.05), and the scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of DAO, TRAF6, IL-1β, IL-6 and MIP-1α in two groups were lower than before treatment (P < 0.05), and the serum levels of these factors in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The synergistic treatment regimen of Qingyi Lidan tablets and Lansoprazole has good safety. By inhibiting systemic inflammatory response and repairing intestinal mucosal barrier function, it can simultaneously improve the symptoms, condition, and overall health status of patients with acute pancreatitis.

R975

北京药学会临床药学研究项目（2019-01-05）