目的 探討胰膽舒膠囊聯(lián)合亞胺培南西司他丁鈉治療急性重癥胰腺炎的臨床療效。方法 選取2019年3月-2020年4月在南陽市中心醫(yī)院進(jìn)行治療的86例急性重癥胰腺炎患者，根據(jù)就診順序分為對(duì)照組（43例）和治療組（43例）。對(duì)照組靜脈滴注注射用亞胺培南西司他丁鈉，1.0 g/次，同0.9%氯化鈉注射液100 mL配伍，每8小時(shí)1次；治療組在對(duì)照組基礎(chǔ)上口服胰膽舒膠囊，2 g/次，3次/d。兩組均經(jīng)2周治療后進(jìn)行效果對(duì)比。觀察兩組的臨床療效，比較兩組臨床癥狀消失時(shí)間、血清學(xué)指標(biāo)、腸道屏障功能指標(biāo)。結(jié)果 經(jīng)治療，對(duì)照組總有效率為81.40%，顯著低于治療組（97.67%，P<0.05）。經(jīng)治療，治療組在口干、腹痛、惡心嘔吐、痞滿燥實(shí)、小便短赤等癥狀消失時(shí)間上均短于對(duì)照組（P<0.05）。經(jīng)治療，兩組血清超敏C反應(yīng)蛋白（hs-CRP）、微管相關(guān)蛋白1輕鏈3（MAP1-LC3）、可溶性髓系細(xì)胞觸發(fā)受體-1（sTREM-1）、腫瘤壞死因子-α（TNF-α）、P物質(zhì)、降鈣素原（PCT）水平均較治療前顯著降低（P<0.05）；治療后，治療組患者血清學(xué)指標(biāo)低于對(duì)照組（P<0.05）。經(jīng)治療，兩組血清淀粉酶（AMS）、二胺氧化酶（DAO）、D-乳酸水平均較治療前顯著降低（P<0.05），并以治療組降低更顯著（P<0.05）。結(jié)論 胰膽舒膠囊聯(lián)合注射用亞胺培南西司他丁鈉治療急性重癥胰腺炎患者具有較好的療效，可有效改善患者臨床癥狀，降低機(jī)體炎癥反應(yīng)，有利于機(jī)體腸道功能的恢復(fù)，有著良好臨床應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Yidanshu Capsules combined with imipenem and cilastatin sodium in treatment of acute severe pancreatitis. Methods A total of 86 patients with acute severe pancreatitis who were treated in Nanyang Central Hospital from March 2019 to April 2020 were selected and divided into control group (43 cases) and treatment group (43 cases) according to the order of treatment. Patients in the control group were iv administered with Imipenem and Cilastatin Sodium for injection, 1.0 g/time combined with 0.9% sodium chloride injection 100 mL, once every 8 h. Patients in the treatment group were po administered with Yidanshu Capsules on the basis of control group, 2 g/time, 3 times daily. The two groups were compared after two weeks of treatment. The clinical efficacy of the two groups was observed, and the time of clinical symptom disappearance, serological indexes and intestinal barrier function indexes were compared between the two groups. Results After treatment, the total effective rate of control group was 81.40%, significantly lower than that of treatment group (97.67%, P<0.05). After treatment, the disappearance time of dry mouth, abdominal pain, nausea and vomiting, fullness and dryness and short red urine in the treatment group was shorter than that in the control group (P<0.05). After treatment, the serum levels of hs-CRP, MAP1-LC3, sSM-1, TNF-α, PCT in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, the serological indexes in treatment group were lower than those in control group (P<0.05). After treatment, the levels of AMS, DAO and D-lactic acid in two groups were significantly decreased compared with before treatment (P<0.05), and the decrease was more significant in the treatment group (P<0.05). Conclusion Yidanshu Capsules combined with imipenem and cilastatin sodium has good curative effect in treatment of acute severe pancreatitis, and can effectively improve the clinical symptoms of patients, also can reduce the inflammatory response of the body, and is conducive to the recovery of intestinal function, which has good clinical application value.

R975

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（142102310250）