生长抑素联合参附注射液治疗胆源性急性胰腺炎的临床观察

目的:观察生长抑素联合参附注射液治疗胆源性急性胰腺炎的疗效及安全性。方法:64例胆源性急性胰腺炎患者,按随机数字表法均分为对照组和研究组。两组患者均给予常规治疗,在此基础上对照组患者给予注射用生长抑素0.25 mg加入5%葡萄糖注射液250 ml中静脉滴注,qd;研究组患者在对照组治疗的基础上给予参附注射液60 ml加入5%葡萄糖注射液250 ml中静脉滴注,qd。两组患者疗程均为两周,治疗期间每日均测血淀粉酶值,待血淀粉酶值恢复正常后停止治疗,治疗结束时未恢复正常者继续治疗。观察两组患者治疗后的C反应蛋白(CRP)、内皮素(ET)-1、肿瘤坏死因子(TNF)-α、血淀粉酶指标水平,记录治愈患者血淀粉酶、血糖、血钙、白细胞恢复正常的时间,比较两组患者的临床疗效;观察两组患者胰腺假性囊肿、胰周脓肿、急性呼吸窘迫综合征、急性肾功能衰竭、心律不齐等并发症发生率及不良反应发生率。结果:研究组患者总有效率显著高于对照组,两组比较差异有统计学意义(P<0.05);研究组患者CRP、ET-1、TNF-α、血淀粉酶水平及血淀粉酶、血糖、血钙、白细胞恢复正常时间均显著优于对照组,两组比较差异均有统计学意义(P<0.05);除急性肾功能衰竭及心律不齐外,研究组患者胰腺假性囊肿、胰周脓肿、急性呼吸窘迫综合征发生率均显著低于对照组,两组比较差异均有统计学意义(P<0.05);两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论:生长抑素联合参附注射液治疗胆源性急性胰腺炎可以明显改善胰腺功能,疗效显著,且安全性较好。

Clinical Observation of Somatostatin Combined with Shenfu Injection in the Treatment of Acute Biliary Pancreatitis

OBJECTIVE： To observe therapeutic efficacy and safety of somatostatin combined with Shenfu injection in the treatment of acute biliary pancreatitis （ABP）. METHODS： A total of 64 ABP patients were randomly divided into control group and re- search group. Both groups were given routine therapy. On the basis of routine therapy, control group was given intravenous dripping of Somatostatin for injection 0.25 mg added into 5% Glucose injection 250 ml once a day; research group was given intrave- nous dripping of Shenfu injection 60 ml added into 5% Glucose injection 250 ml once a day on the basis of control group. Treat- ment course of 2 groups lasted for 2 weeks. The level of hemodlastase was determined in 2 groups, and therapy discontinued after it returned to normal. At the end of treatment, the patients who were not recovered continued the treatment. C reaction protein （CRP）, endothelin-1 （ET-1）, TNF-α and hemodlastase were compared between 2 groups; the normal durations of hemodlastase, blood glucose （BG）, blood calcium and serum WBC were also recorded in 2 groups. Clinical efficacies of 2 groups were compared. The incidence of complications, such as pancreatic pseudocyst, parapancreatic abscess, acute respiratory distress syndrome, acute renal failure and arrhythmia, and ADR were also observed in 2 groups. RESULTS： Total effective rate of research group was significantly higher than that of control group; there was statistical significance （P〈0.05）. The indexes of CRP, ET-1, TNF-α and hemodlastase, the normal durations of hemodlastase, BG, blood calcium and serum WBC in research group were significantly better than in control group （P〈0.05）. The incidence of pancreatic pseudocyst, parapancreatic abscess and the incidence of acute respiratory distress syndrome in study group were significantly lower than in control group; there was statistical significance （P〈 0.05）; there was no statistical significance in the incidence of arrhythmia （P〉0.05） ; there was no statistical significance in the incidence of ADR between 2 groups （P〉0.05）. CONCLUSIONS： Somatostatin combined with Shenfu injection have significant effect on ABP with sound safety.