目的 探討清胰利膽片聯(lián)合蘭索拉唑治療急性胰腺炎的臨床療效。方法 選取2021年6月—2024年4月首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院收治的急性胰腺炎患者94例，隨機(jī)分為對照組和治療組，每組各47例。對照組靜脈滴注注射用蘭索拉唑，30 mg加入100 mL生理鹽水，2次/d。在對照組基礎(chǔ)上，治療組口服清胰利膽片，6片/次，3次/d。兩組患者療程均為10 d。觀察兩組患者臨床療效，比較治療前后兩組患者臨床恢復(fù)參數(shù)，慢性健康狀況評分系統(tǒng)Ⅱ（APACHEⅡ）、改良CT嚴(yán)重指數(shù)（MCTSI）和急性胰腺炎嚴(yán)重程度床邊指數(shù)（BISAP）評分，及血清二胺氧化酶（DAO）、腫瘤壞死因子受體相關(guān)因子6（TRAF6）、白細(xì)胞介素-1β（IL-1β）、IL-6和巨噬細(xì)胞炎性蛋白-1α（MIP-1α）水平。結(jié)果 治療后，治療組總有效率明顯高于對照組（93.62% vs 78.72%，P＜0.05）。治療后，治療組各項癥狀（腹痛、腹脹等）及體征（腸鳴音、腹內(nèi)高壓）的消失時間和血淀粉酶復(fù)常時間均顯著短于對照組（P＜0.05）。治療后，兩組APACHEⅡ、MCTSI和BISAP評分均低于同組治療前（P＜0.05），且治療組評分明顯低于對照組（P＜0.05）。治療后，兩組血清DAO、TRAF6、IL-1β、IL-6和MIP-1α水平均低于組內(nèi)治療前（P＜0.05），且治療組患者這些血清因子水平明顯低于對照組（P＜0.05）。結(jié)論 清胰利膽片與蘭索拉唑的協(xié)同治療方案有良好的安全性，通過抑制全身炎癥反應(yīng)和修復(fù)腸黏膜屏障功能，能同步改善急性胰腺炎患者的癥狀、病情及整體健康狀態(tài)。

Objective To investigate the clinical efficacy of Qingyi Lidan Tablets combined with lansoprazole in treatment of acute pancreatitis. Methods Patients (94 cases) with acute pancreatitis in Beijing Tongren Hospital Affiliated to Capital Medical University from June 2021 to April 2024 were randomly divided into control and treatment group, and each group had 47 cases. Patients in the control group were iv administered with Lansoprazole for injection, 30 mg was added into 100 mL normal saline, twice daily. Patients in the treatment group were po administered with Qingyi Lidan Tablets on the basis of the control group, 6 tablets/time, three times daily. Patients in two groups were treated for 10 d. After treatment, the clinical evaluations were evaluated, and the clinical recovery parameters, the APACHE II, MCTSI, and BISAP scores, and the serum DAO, TRAF6, IL-1 β, IL-6, and MIP-1α levels in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (93.62% vs 78.72%, P < 0.05). After treatment, the disappearance time of various symptoms (abdominal pain, abdominal distension, etc.) and signs (bowel sounds, intra-abdominal hypertension) and the recovery time of blood amylase in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the APACHEⅡ, MCTSI and BISAP scores in two groups were lower than those in the same group before treatment (P < 0.05), and the scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of DAO, TRAF6, IL-1β, IL-6 and MIP-1α in two groups were lower than before treatment (P < 0.05), and the serum levels of these factors in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The synergistic treatment regimen of Qingyi Lidan tablets and Lansoprazole has good safety. By inhibiting systemic inflammatory response and repairing intestinal mucosal barrier function, it can simultaneously improve the symptoms, condition, and overall health status of patients with acute pancreatitis.

R975

北京藥學(xué)會臨床藥學(xué)研究項目（2019-01-05）