生长抑素联合复方丹参注射液治疗急性胰腺炎临床研究

Effect of somatostatin combined with compound salvia miltiorrhiza injection(复方丹参注射液) on patients with acute pancreatitis

目的:观察生长抑素联合复方丹参注射液治疗急性胰腺炎(AP)的临床疗效。方法:采用随机对照分组的临床研究方法,将2002年6月—2006年12月收治的62例AP患者分为对照组和观察组,每组31例。对照组在常规禁食、胃肠减压等治疗的基础上,先静脉注射生长抑素250μg,然后改用3 000μg加生理盐水500 ml以250μg/h的速度持续静脉滴注(静滴),连续7～14 d;观察组在对照组治疗基础上,予复方丹参注射液20 ml溶于生理盐水250 ml中静滴,每日1次,连续7～14 d。观察并比较两组患者的症状,腹部体征消失时间,血、尿淀粉酶,肝功能恢复正常时间,血钙浓度变化和多器官功能障碍综合征(MODS)发生率、病死率。结果:观察组治疗后血淀粉酶显著低于对照组,而血钙水平显著高于对照组,尤以治疗后3 d和5 d更为明显(P均<0.01)。观察组痊愈率(38.7%)和总有效率(90.4%)均明显高于对照组(16.2%和77.4%,P<0.01和P<0.05),而MODS的发生率(19.3%)和病死率(6.5%)均显著低于对照组(45.1%和16.2%,P均<0.05)。结论:生长抑素联合复方丹参注射液治疗AP疗效好于单纯生长抑素治疗。

Objective： To observe the therapeutic efficacy of somatostatin combined with compound salvia miltiorrhiza injection （复方丹参注射液）on patients with acute pancreatitis （AP）. Methods： By using randomized controlled trail, 62 patients with AP were divided into control group （31 cases） and observation group （31 cases） in a period from June, 2002 to December, 2006. In the control group, routine measures, such as forbidding food, decompressing stomach and intestines, were taken, and in addition, intravenous injection of somatostatin 250 μg with subsequent intravenous drip 3 000 μg in normal saline 500 ml at a rate of 250 μg/h once everyday was used for 7 - 14 days. On the above treatment of the control group, compound salvia miltiorrhiza injection 20 ml in normal saline 250 ml, intravenous drip every day for 7 - 14 days, was added in the observation group. The disappearance of symptoms and abdominal signs, amylase of urine and blood, the time of recovery of hepatic function, change of calcium concentration, incidences of multiple organ dysfunction syndrome （MODS） and case fatality were observed and compared. Results ： Amylase of blood after treatment in observation group was lower than that in the control group, while serum calcium concentration was higher, especially on 3 and 5 days after treatment （all P〈0. 01）. The cure rate and total efficacy rate were significantly higher in observation group （38.7% and 90. 4%） than those in the control group（16.2% and 77.4%, P〈0. 01 and P〈0.05）, while the incidences of MODS and case fatality were obviously less in observation group （19.3%and 6.5%） than those in the control group（45.1% and 16.2%, both P〈0. 05）. Conclusion： Somatostatin combined with compound salvia miltiorrhiza for treatment of patients with AP is more effective.