血必净注射液联合西医常规疗法治疗重症急性胰腺炎的临床研究

Effective analysis on the treatment of severe acute pancreatitis withXueBiJing injection and conventional therapy of western medicine

目的：评价血必净注射液联合西医常规疗法治疗重症急性胰腺炎（severe acute pancreatitis, SAP）的临床疗效。方法本研究为随机对照研究。将符合纳入标准的SAP患者采用随机数字表法分为常规治疗组（52例）和血必净治疗组（52例）。常规治疗组采用抑酶和抗感染等治疗，血必净治疗组在常规治疗组基础上加用血必净注射液治疗，均治疗7 d。检测白细胞计数（white blood cell count, WBC）、C反应蛋白（C-reactive protein, CRP）、血和尿淀粉酶、肿瘤坏死因子-α（tumor necrosis factor-α, TNF-α）、内毒素（lipopolysaccharide, LPS）、白细胞介素-6（interleukin-6, IL-6），并评价临床疗效。结果血必净治疗组和常规治疗组总有效率分别为92.31%（48/52）和73.08%（38/52），2组比较差异有统计学意义（χ2＝5.442， P＝0.020）。血必净治疗组治疗后 WBC[（9.2±2.1）×109/L 比（12.2±3.1）×109/L，t＝5.778]、血淀粉酶[（305.4±100.9）U/L比（403.5±197.8）U/L，t＝3.186]、尿淀粉酶[（702.3±98.5）U/L比（1102.4±202.6）U/L，t＝12.807]、TNF-α[（21.2±9.1）ng/ml比（27.5±13.4）ng/ml，t＝2.805]、CPR[（7.6±3.8）mg/L比（15.2±9.8）mg/L，t＝5.214]、LPS[（146.3±52.1）U/L 比（281.2±91.7）U/L，t＝9.224]、IL-6[（143.4±52.4）ng/ml比（203.7±79.8）ng/ml，t＝4.555]均较常规治疗组治疗后降低（P＜0.01）。血必净治疗组腹胀缓解时间[（5.3±1.3）d比（6.1±2.5）d，t＝2.047]、腹痛缓解时间[（4.9±2.3）d比（6.0±3.1）d，t＝2.055]、体温恢复时间[（4.3±1.8）d 比（5.5±2.1）d，t＝3.129]较常规治疗组明显缩短（P＜0.05）。结论血必净注射液联合常规疗法可有效缓解SAP的症状及体征，降低血和尿淀粉酶，缩短治愈时间。

Objective To evaluate the effects of treating severe acute pancreatitis （SAP） with XueBiJing injection and conventional therapy of western medicine.Methods This study was a randomized controlled study. 104 patients meet the inclusion criteria of SAP were randomly divided into a routine treatment group （52 cases） and aXuebijing treatment group （52 cases）. Patients of both groups received immediate rescue together with performing ECG monitoring, fasting food, inhaling oxygen. On such basis, the conventional treatment group was treated with inhibiting enzyme activity and resisting infection; WhileXuebijing treatment group was treated withXuebijing injection on the basis of the conventional treatment group. After 7 days treatment, the therapeutic effect, WBC, CRP, blood and urinary amylase, TNF-α, LPS, and IL-6 were observed in both groups.Results The total effective rates in the treatment group and the control group were 92.31%（48/52）and 73.08%（38/52）, respectively, with statistical difference（χ2=5.442,P=0.020）. After the treatment, WBC （9.2 ＆#215;109/L ± 2.1 ×109/Lvs.12.2 ×09/L ± 3.1 ＆#215;109/L;t=5.778,P=0.000）, amylase blood serum （305.4 ± 100.9 U/Lvs. 403.5 ± 197.8 U/L;t=3.186,P=0.002） and urine （702.3 ± 98.5 U/Lvs.1 102.4 ± 202.6 U/L;t=12.807,P=0.000）, TNF-α （21.2 ± 9.1 ng/mlvs.27.5 ± 13.4 ng/ml;t=2.805,P=0.006）, CPR （7.6 ±3.8 mg/Lvs.15.2 ± 9.8 mg/L;t=5.214,P=0.000）, LPS （146.3 ± 52.1 EU/Lvs.281.2 ± 91.7 EU/L;t=9.224, P=0.000）, and IL-6 （143.4 ± 52.4 ng/mlvs. 203.7 ± 79.8 ng/ml;t=4.555,P=0.000） in the treatment group were significantly reduced than those in the control group. The times to remission of abdominal distension （5.3 ± 1.3 d vs.6.1 ± 2.5 d;t=2.047,P=0.043） and abdominal paln （4.9 ± 2.3 dvs.6.0 ± 3.1 d;t=2.055,P=0.042）, return to normal body temperature （4.3 ± 1.8 dvs.5.5 ± 2.1 d;t=3.129,P=0.002） in the treatment group were all significantly decreased than those in the control group.ConclusionXueBiJinginjection adjuvant to conventional therapy can effectively improve reduction of amylase in blood serum and urine, and symptoms remission,and also shorten treatment time in patients with SAP.