乌司他丁联合参麦注射液治疗急性重症胰腺炎疗效观察

Clinlical effect of combined use of ulinastin and Shenmai injection for the treatment of severe acute pancreatitis

目的研究以乌司他丁联合应用参麦注射液治疗急性重症胰腺炎,比较患者单独和联合用药的疗效。方法选取2010年至2013年间收治的急性重症胰腺炎患者40例,随机分为两组:实验组(20例)予联合用药治疗,对照组(20例)予单独应用乌司他丁治疗。采用SPSS13.0软件分析,血尿淀粉酶和APACHEⅡ评分用(x珋±s)表示,采用t检验;综合疗效评价以率(%)表示,采用χ2检验。P<0.05表示有统计学意义。结果两组患者治疗前,治疗后10 d血尿淀粉酶各指标,差异均无统计学意义;而治疗后5 d、7 d两组差异有统计学意义(t=2.522、3.526、3.051、3.142,P<0.05)。5 d、7 d APACHEⅡ评分,实验组(12±4.4)、(8.1±3.4),对照组(15.4±4.3)、(12.7±3.3)各组指标均数对比实验组效果优于对照组,差异均有统计学意义(t=2.639、2.198,P<0.05)。实验组总有效率为95.0%(19/20)明显高于对照组60.0%(12/20),差异有统计学意义(χ2=7.03,P<0.05),表明联合用药疗效较单独应用乌司他丁疗效好。结论对于急性重症胰腺炎,乌司他丁与参麦注射液联合应用可控制病情的发展、提高治愈率,有重要临床意义,值得推广。

Objective To investigate the curative effect of severe acute pancreatitis （SAP） by using ulinastin and/or Shenmai injection . Methods From 2010 to 2013, 40 patients with SAP were treated in our hospital.They were randomly divided into two groups： experimental group （20 patients） and control group （ 20 patients ） . The experimental group received combined therapy with ulinastin and Shenmai injection, and the control group was subjected to single-drug therapy.SPSS13.0 software was used to analyze clinical data including biood/urine amylase and APACHEⅡscore.The data were measured as mean ±SD and compared using independent samples t test .Total effective rate （%） was compared by using the Chi-square test.A P value less than 0.05 was considered statistically significant . Results There was no statistically significant difference between the two groups , including biood/urine amylase before and 10 days after treatment.However there was significant difference between the two groups at 5 days and 7 days after treatment（t=2.522、3.526、3.051 and 3.142 respectively, P〈0.05）.APACHEⅡscores at 5 days and 7 days after treatment in the exprerimental group were （12 ±4.4） and （8.1 ±3.4） respectively, whereas in the control group （15.4 ±4.3） and （12.7 ±3.3） respectively, with significant difference between the two groups （t=2.639, 2.198, P﹤0.05）.The total effective rate in the exprerimental group was 95.0%（19/20）, but in control group 60.0% （12/20）, with a significant difference （χ^2 =7.03, P 〈0.05）. Conclusion Combined ulinastin and Shenmai injection proved to be effective in treating SAP .The regimen could slow down the process of SAP in early stage and improve the recovery rate .Combined ulinastin and Shenmai injection is worth popularizing in the treatment of SAP .