血必净联合乌司他丁及奥曲肽治疗重症急性胰腺炎的有效性及对炎症指标的影响

Efficacy of Xuebijing combined with ulinastatin and octreotide in the treatment of severe acute pancreatitis and its influence on inflammatory indicators

摘要:

目的 探究重症急性胰腺炎（SAP）予以血必净、乌司他丁及奥曲肽联合治疗的有效性及对炎症指标影响。方法 选择2021年10月至2024年8月，选择中国人民解放军联勤保障部队第九〇八医院收治的60例SAP患者，按随机数字表法分2组，各30例。对照组予以乌司他丁及奥曲肽治疗，观察组联合血必净治疗，均持续治疗10 d。比较两组临床疗效、炎症指标、肠黏膜损伤程度、免疫功能、不良反应。结果 观察组治疗总有效率（93.33%）较对照组（73.33%）高，治疗后肿瘤坏死因子-α（TNF-α）（20.53±1.55）pg/mL、降钙素原（PCT）（3.42±0.53）mg/L、C反应蛋白（CRP）（43.55±2.76）mg/L、白细胞介素-6（IL-6）（35.75±2.46）pg/mL均较对照组低，D-乳酸、血清内毒素均较对照组低，CD3⁺、CD4⁺均较对照组高，CD8⁺较对照组低，有统计学差异（P＜0.05）；对比两组不良反应，无统计学差异（P＞0.05）。结论 血必净联合乌司他丁及奥曲肽治疗SAP患者可有效减轻炎症反应及肠黏膜损伤，改善免疫功能，且安全可靠。

Abstract:

Objective To investigate the effectiveness of Xuebijing combined with ulinastatin and octreotide in the treatment of severe acute pancreatitis (SAP), and to study its influence on inflammatory indicators.Methods From October 2021 to August 2024, 60 cases of SAP who treated in the 908th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army were divided into two groups, with 30 cases in each group, using a random number table method. The patients in the control group took ulinastatin and octreotide, and the patients in the observation group added Xuebijing, both groups received continuous treatment for 10 days. The comparisons were performed on the clinical efficacy, inflammatory indicators, degree of intestinal mucosal injury, immune function and adverse reactions in both groups.Results The total effective rate of the observation group (93.33%) was higher than that of the control group (73.33%). After treatment, tumor necrosis factor-α (TNF α) (20.53±1.55) pg/mL, procalcitonin (PCT) (3.42±0.53) mg/L, C-reactive protein (CRP) (43.55±2.76) mg/L, interleukin-6 (IL-6) (35.75±2.46) pg/mL were lower than those of the control group. D-lactic acid and serum endotoxin were lower than those of the control group. CD3⁺ and CD4⁺ were higher than those of the control group. CD8⁺ was lower than that of the control group.The difference was statistically significant (P＜0.05); There was no significant difference in adverse reactions between the two groups (P＞0.05).Conclusion Xuebijing combined with ulinastatin and octreotide in the treatment of SAP patients can effectively reduce the inflammatory reaction and intestinal mucosal damage, and improve immune function, which is safe and reliable.