目的 探讨黄芪注射液联合加贝酯治疗急性胰腺炎的临床疗效。方法 纳入2022年3月—2025年6月首都医科大学附属北京友谊医院收治的146例急性胰腺炎患者，以随机数字表法分为对照组和治疗组，每组各73例。对照组患者静脉滴注注射用甲磺酸加贝酯，0.1g /次，溶于5 mL注射用水溶解后，转移至5%葡萄糖注射液500 mL中，起始3天，3次/d，症状缓解后改为1次/d，严格控制滴注速度，≤1 mg/(kg·h)。治疗组在对照组治疗基础上联合黄芪注射液静脉滴注治疗，20 mL/次，加入5%葡萄糖注射液250 mL中使用，1次/d。两组疗程10 d。观察两组临床疗效和临床表现消失时间，比较治疗前后简明急性生理学评分Ⅱ（SAPS Ⅱ）、改良CT严重指数（MCTSI）、胰腺炎活动度评分系统（PASS）和血清胱天蛋白酶募集域蛋白9（CARD9）、可溶性E-选择素（sE-selectin）、谷胱甘肽过氧化物酶（GSH-Px）、丙二醛（MDA）、D-乳酸（D-LA）、二胺氧化酶（DAO）水平。结果 治疗组总有效率是91.78%，较对照组（78.08%）更高（P＜0.05）。治疗过程中，治疗组上腹压痛消失时间、腹胀消失时间、腹痛消失时间、肠鸣音恢复时间、血清淀粉酶复常时间都短于对照组（P＜0.05）。治疗后，两组SAPS Ⅱ评分、MCTSI评分和PASS评分均较同组治疗前显著降低（P＜0.05）；治疗后治疗组SAPS Ⅱ评分、MCTSI评分和PASS评分都低于对照组（P＜0.05）。治疗后，两组患者血清CARD9、sE-selectin、MDA、D-LA、DAO水平降低，血清GSH-Px水平上升（P＜0.05）；治疗组血清CARD9、sE-selectin、MDA、D-LA、DAO水平低于对照组，GSH-Px水平高于对照组（P＜0.05）。结论 急性胰腺炎应用黄芪注射液联合加贝酯治疗能有效抑制急性胰腺炎患者机体炎症反应和氧化应激状态，促进胰腺微循环和肠道屏障功能恢复，从而加速患者症状消除和病情好转。

Objective To investigate the clinical efficacy of Huangqi Injection combined with gabexate in treatment of acute pancreatitis. Methods A total of 146 patients with acute pancreatitis who were admitted to Beijing Friendship Hospital Affiliated to Capital Medical University from March 2022 to June 2025 were included. They were randomly divided into control group and treatment group (73 cases each) using a random number table method. Patients in control group patients were given intravenous infusion of Gabexate Mesylate for injection at a dose of 0.1 g per time, dissolved in 5 mL of injection water, and then transferred to 5% glucose injection solution of 500 mL. The treatment was initiated for 3 d, 3 times daily. After symptom relief, it was changed to 1 time per day. The infusion speed was strictly controlled, ≤1 mg/(kg∙h). Patients in treatment group were treated in addition to control group with intravenous infusion of Huangqi Injection at a dose of 20 mL per time, added to 250 mL of 5% glucose injection solution, once daily. The treatment course for both groups was 10 d. The clinical efficacy and disappearance time of clinical manifestations of two groups were observed, and the simplified acute physiology score II (SAPS II), modified CT severity index (MCTSI), pancreatic inflammation activity scoring system (PASS), and serum levels of cysteine protease recruitment domain protein 9 (CARD9), soluble E-selectin (sE-selectin), glutathione peroxidase (GSH-Px), malondialdehyde (MDA), D-lactic acid (D-LA), and diamine oxidase (DAO) were compared before and after treatment. Results The total effective rate of the treatment group was 91.78%, which was higher than that of the control group (78.08%) (P < 0.05). During the treatment process, the disappearance time of upper abdominal tenderness, abdominal distension, abdominal pain, recovery time of bowel sounds, and normalization time of serum amylase in the treatment group were all shorter than those in the control group (P < 0.05). After treatment, the SAPS II score, MCTSI score, and PASS score of both groups were significantly lower than those before treatment in the same group (P < 0.05). After treatment, the SAPS II score, MCTSI score, and PASS score of treatment group were all lower than those of control group (P < 0.05). After treatment, the levels of serum CARD9, sE-selectin, MDA, D-LA, and DAO in both groups decreased, but the level of serum GSH-Px increased (P < 0.05). The levels of serum CARD9, sE-selectin, MDA, D-LA, and DAO in treatment group were lower than those in control group, and the level of GSH-Px was higher than that in control group (P < 0.05). Conclusion The application of Huangqi injection combined with gabexate in the treatment of acute pancreatitis can effectively inhibit the inflammatory response and oxidative stress state of patients with acute pancreatitis, promote the recovery of pancreatic microcirculation and intestinal barrier function, thereby accelerating the elimination of symptoms and improvement of the patient's condition.

吴阶平医学基金会临床科研专项资助基金（320.6750.2022.26-15）