目的 探討清胰利膽顆粒聯(lián)合烏司他丁和生長(zhǎng)抑素治療急性重癥胰腺炎的臨床療效。方法 選取2015年3月-2016年3月在海南醫(yī)學(xué)院附屬醫(yī)院接受治療的急性胰腺炎患者88例，根據(jù)治療方案的差別分為對(duì)照組和治療組，每組各44例。對(duì)照組給予注射用烏司他丁，10萬U微量泵24 h持續(xù)輸入；同時(shí)給予注射用生長(zhǎng)抑素，6 mg/d，微量泵24 h持續(xù)輸入。治療組在對(duì)照組基礎(chǔ)上口服清胰利膽顆粒，1袋/次，3次/d。兩組患者均治療7 d。觀察兩組患者的臨床療效，比較兩組的臨床癥狀消失時(shí)間、炎性因子、淀粉酶（AMS）、脂肪酶（LPS）和對(duì)氧磷酶1（PON1）的變化。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為81.82%、95.45%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組腹脹、腹痛、惡心嘔吐及腹膜刺激征消失時(shí)間明顯短于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者血清腫瘤壞死因子α（TNF-α）、白細(xì)胞介素-6（IL-6）、白細(xì)胞介素-8（IL-8）的水平均顯著降低，而白細(xì)胞介素-10（IL-10）的水平明顯升高，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者AMS和LPS水平顯著降低，而PON1水平明顯升高，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 清胰利膽顆粒聯(lián)合烏司他丁和生長(zhǎng)抑素治療急性重癥胰腺炎療效顯著，可明顯改善患者臨床癥狀，降低血清炎性因子水平，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Qingyi Lidan Granula combined with ulinastatin and somatostatin in treatment of severe acute pancreatitis. Methods Patients (88 cases) with severe acute pancreatitis in the Affiliated Hospital of Hainan Medical University from March 2015 to March 2016 were enrolled in this study. According to the different treatment plans, patients were divided into the control and treatment groups, and each group had 44 cases. Patients in the control group were given Ulinastatin for injection, micro pump infusion of 100 000 U for 24 h. And patients in the control group were given Somatostatin for injection, micro pump infusion of 6 mg/d for 24 h. Patients in the treatment group were po administered with Qingyi Lidan Granula on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and the changes of clinical symptoms disappearance time, inflammatory factors, AMS, LPS, and PON1 in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.82% and 95.45%, respectively, and there was difference between two groups (P<0.05). After treatment, the disappearance time of abdominal distension, abdominal pain, nausea and vomiting, and peritoneal irritation in the treatment group were shorter than those in the control group (P<0.05). After treatment, the levels of TNF-α, IL-6, and IL-6 in two groups were significantly decreased, but the levels of IL-10 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of AMS and LPS in two groups were significantly decreased, but the levels of PON1 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Qingyi Lidan Granula combined with ulinastatin and somatostatin has the clinical curative effect in treatment of severe acute pancreatitis, and could significantly improve clinical symptoms, reduce the level of serum inflammatory factors, which has a certain clinical application value.