思他宁和加贝酯治疗急性胰腺炎疗效观察

Observation on the Effectiveness of Stilamin and Gabexate in the Treatment of Patients with Acute Pancreatitis

目的:评价生长抑素(somatostatin,商品名Stilamin,思他宁)和甲磺酸加贝酯(gabexate mesilate,GM)治疗急性胰腺炎患者的疗效,及这两种药物对急性出血坏死型胰腺炎的临床疗效。方法:采用随机对照研究,按是否出血坏死型随机分为治疗组和对照组,在常规治疗的基础上,分别接受思他宁或甲磺酸加贝酯治疗,并观察疗效。结果:思他宁用于治疗急性水肿型胰腺炎,总有效率达100.0%,痊愈率达78.9%,略高于对照组加贝酯(63.6%),但差异无显著性(P>0.05)。腹痛、上腹胀等症状均能在3～5d内基本缓解或消失。思他宁用于治疗急性出血坏死型胰腺炎,总有效率90%,高于对照组加贝酯66.7%,差异有显著性(P<0.05)。治疗过程中仅2例丙氨酸转氨酶轻度升高,未发现过敏、皮疹、白细胞明显下降等明显不良反应,肝、肾功能和电解质等生化指标和血常规监测显示其具有较好的安全性。结论:思他宁和加贝酯用于治疗急性水肿型胰腺炎和出血坏死型胰腺炎均有较好的疗效,不良反应较少。在急性水肿型胰腺炎治疗中,二者总有效率无显著性差异;在出血坏死型胰腺炎治疗中,思他宁总有效率高于加贝酯。

Objective：To assess the effectiveness of somatostatin （Stilamin） and gabexate mesilate（GM） in the treatment of patients with acute edematic pancreatitis （AEP） and acute hemorragic and necrotic pancreatitis （AHNP）.Methods：Patients were randomly alloccated into the treatment group （with Stilamin） and control group （with gabexate ） which were stratified by AHNP or AEP.All the side effects were recorded during the whole process.Results：Totally 57 acute pancreatitis patients were enrolled （male 31,female 26）.Among them,41 cases were mild,16 cases were severe.The study showed that total ef2 fectiveness of Stilamin in treating acute pancreatitis was 100 %,while the cured rate was 78.9 %,a little bit higher than control group with cabexate （63.6 %）,but no statistical significance existed.Total effectiveness of Stilamin in treating AHNP was similar as that of sandostatin （90.0 % vs 66.7 %,P = 0.031）.The main complication after treating AHNP was pancreatic pseudocyst.Only two case showed increase of ALT.No side effects of hypersensitivity,skin rash,WBC decrease were noted.Safety had been proved by monitoring of liver and renal function,eletrolytes and blood RT.Conclusion：Stilamin and gabexate showed effectiveness in treating AEP and AHNP with fewer side effects.The total effectiveness of Stilamin in treating AHNP was higher than control group with gabexate,and statistical significance existed.