目的 觀察參麥注射液聯(lián)合奧曲肽治療急性胰腺炎的臨床療效。方法 選取2012年1月—2015年1月廣州醫(yī)科大學(xué)附屬第五醫(yī)院普通外科收治的急性胰腺炎患者78例,隨機(jī)分為對照組和治療組,每組各39例。對照組患者在基礎(chǔ)治療上靜脈滴注醋酸奧曲肽注射液,0.6 mg奧曲肽加入250 mL生理鹽水后以25 μg/h的滴速持續(xù)靜脈泵入,1次/d。治療組在對照組治療基礎(chǔ)上靜脈滴注參麥注射液,100 mL/次,1次/d。兩組均連續(xù)治療10 d。觀察兩組的臨床療效,同時比較兩組臨床癥狀、體征改善情況及實驗室相關(guān)指標(biāo)的變化。結(jié)果 治療后,對照組和治療組的總有效率分別為87.18%、97.44%,兩組比較差異有統(tǒng)計學(xué)意義(P <0.05)。治療組腹痛、腹脹、壓痛消失時間及排氣恢復(fù)時間均顯著低于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P <0.05)。治療后,兩組患者天門冬氨酸氨基轉(zhuǎn)移酶(AST)、丙氨酸氨基轉(zhuǎn)氨酶(ALT)均從治療1 d開始下降,血尿淀粉酶、尿淀粉酶、血尿素氮(BUN)、血肌酐(Cr)、C反應(yīng)蛋白(CRP)從治療5 d開始下降,同組治療前后差異具有統(tǒng)計學(xué)意義(P <0.05);且治療組的下降程度優(yōu)于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P <0.05)。治療組中轉(zhuǎn)手術(shù)治療、平均住院時間均顯著低于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P <0.05)。結(jié)論 參麥注射液聯(lián)合奧曲肽治療急性胰腺炎具有較好的臨床療效,可顯著緩解患者的臨床癥狀和體征,同時又能降低實驗室相關(guān)指標(biāo),具有一定的臨床應(yīng)用價值。

Objective To observe the clinical effect of Shenmai Injection combined with octreotide in treatment of acute pancreatitis. Methods Patients (78 cases) with acute pancreatitis in Department of General Surgery of the Fifth Affiliated Hospital of Guangzhou Medical University from January 2012 to January 2015 were randomly divided into control and treatment groups, and each group had 39 cases. The patients in the control group wereiv administered with Octreotide Acetate Injection on the basis of foundation treatment (0.6 mg adding into 250 mL physiological saline), and they were continuous intravenous pumping with the dripping speed of 25 μg/h, once daily. The patients in the treatment group were iv administered with Shenmai Injection on the basis of the treatment group, 100 mL/time, once daily. Two groups were treated for 10 d. After treatment, the efficacy was evaluated, and the improvement of clinical symptoms and signs and the changes of laboratory related indicators in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 87.18% and 97.44%, respectively, and there was difference between two groups (P < 0.05). The disappear time of abdominal pain, abdominal distention and tenderness, and recovery time of exhaust in the treatment group were significantly lower than the control group, and there was difference between two groups (P < 0.05). After treatment, AST and ALT began to decline from the first day of the treatment, while blood amylase, urine amylase, BUN, Cr and CRP began to decline from the fifth day of the treatment, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). The number of transit operation treatment and average time of hospital stay in the treatment group were significantly lower than those in the control group, with significant differences between two groups (P < 0.05). Conclusions Shenmai Injection combined with octreotide has good clinical efficacy in treatment of acute pancreatitis, and can significantly relieve the clinical signs and symptoms, also can reduce the laboratory related indicators, which has a certain clinical application value.