目的 探究胰膽舒膠囊聯合烏司他丁治療急性胰腺炎的臨床效果。方法 選取2019年1月—2020年1月來武警特色醫(yī)學中心和南開醫(yī)院進行治療的120例急性胰腺炎患者，隨機分成對照組（n=60）和治療組（n=60）。對照組靜脈滴注注射用烏司他丁，10萬U與生理鹽水250 mL混合，2次/d。治療組在對照組治療基礎上口服胰膽舒膠囊，3粒/次，3次/d。兩組均連續(xù)治療14 d。觀察兩組臨床療效，對兩組的臨床癥狀緩解時間、各生化指標水平和炎癥因子水平進行比較。結果 治療后，治療組的總有效率為96.67%，顯著高于對照組的75.00%（P<0.05）。治療組體溫恢復時間、排氣恢復時間、血淀粉酶恢復時間、尿淀粉酶恢復時間、惡心/嘔吐消失時間、腹痛消失時間、腹水消失時間均顯著短于對照組（P<0.05）。治療后兩組患者總膽固醇（TC）、三酰甘油（TG）、血清淀粉酶（AMS）、血清脂肪酶（LPS）、天門冬氨酸氨基轉移酶（AST）均顯著降低（P<0.05）；治療后治療組患者各生化指標水平均低于對照組（P<0.05）。治療后，兩組的血清C反應蛋白（CRP）、白細胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）水平均顯著降低，但血清白細胞介素-10（IL-10）水平均升高（P<0.05）；治療后，治療組CRP、IL-6、TNF-α低于對照組，而IL-10高于對照組（P<0.05）。結論 胰膽舒膠囊聯合烏司他丁治療急性胰腺炎具有較好的臨床療效，能夠快速緩解臨床癥狀，改善各生化指標，緩解炎性反應，且無明顯不良反應，具有一定的臨床推廣應用價值。

Objective To investigate the clinical effect of Yidanshu Capsules combined with ulinastatin in treatment of acute pancreatitis. Methods A total of 120 patients with acute pancreatitis who were treated in the Armed Police Special Medical Center and Nankai Hospital from January 2019 to January 2020 were randomly divided into control group (n=60) and treatment group (n=60). Patients in the control group were iv administered with Ulinastatin for injection, 100 000 U was mixed with normal saline 250 mL, twice daily. Patients in the treatment group were po administered with Yidanshu Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the remission time of clinical symptoms, the levels of biochemical indexes and inflammatory factors were compared between two groups. Results After treatment, the total effective rate of the treatment group was 96.67%, which was significantly higher than that of the control group (75.00%, P<0.05). The recovery time of body temperature, exhaust, blood amylase, urinary amylase, disappearance time of nausea/vomiting, abdominal pain and ascites in treatment group were significantly shorter than those in control group (P<0.05). After treatment, total cholesterol (TC), triglyceride (TG), serum amylase (AMS), serum lipase (LPS), and aspartate aminotransferase (AST) in two groups were significantly decreased (P<0.05). After treatment, the biochemical indexes in the treatment group were lower than those in the control group (P<0.05). After treatment, the serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in both groups were significantly decreased, but the serum levels of interleukin-10 (IL-10) were increased (P<0.05). After treatment, CRP, IL-6 and TNF-α in treatment group were lower than those in control group, while IL-10 was higher than those in control group (P<0.05). Conclusions Yidanshu Capsules combined with ulinastatin has a good clinical effect in treatment of acute pancreatitis, and can quickly alleviate clinical symptoms, improve biochemical indicators, alleviate inflammatory response, and has no obvious adverse reactions, which has a certain value of clinical application.

R975

天津市衛(wèi)生和計劃生育委員會科研基金資助項目（2017KZ089）