埃索美拉唑联合生长抑素治疗重症胰腺炎的效果

Effect of Esomeprazole combined with Somatostatin in the treatment of severe acute pancreatitis

目的探索埃索美拉唑联合生长抑素(SS)治疗重症胰腺炎(SAP)的效果及其对患者肠道黏膜屏障功能和炎性递质水平的影响。方法选取2015年10月~2017年10月我院收治的84例SAP患者作为研究对象,将其随机分为对照组和观察组,每组各42例。对照组患者采取常规对症支持治疗,观察组在对照组基础上,同时给予埃索美拉唑联合SS治疗。比较两组治疗后的症状指标、总体治疗效果、肠道黏膜屏障功能及炎性递质水平。结果治疗后,观察组患者的腹痛腹胀缓解时间、排气恢复时间、血淀粉酶恢复正常时间均明显短于对照组,差异有统计学意义(P<0.05)。观察组患者的治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的D-乳酸、DAO、内毒素、L/M值水平均低于治疗前,差异有统计学意义(P<0.05);观察组患者治疗后的D-乳酸、DAO、内毒素、L/M值水平均低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的IL-6、IL-8、CRP、TNF-α水平均低于治疗前,差异均有统计学意义(P<0.05);观察组患者治疗后的IL-6、IL-8、CRP、TNF-α水平均低于对照组,差异均有统计学意义(P<0.05)。结论埃索美拉唑联合SS治疗SAP能改善患者症状,提高治疗有效率,促进肠道黏膜屏障功能恢复,降低炎性递质水平,值得在临床中应用。

Objective To explore the effect of Esomeprazole combined with Somatostatin（SS） in the treatment of severe acute pancreatitis（SAP） and its effect on intestinal mucosal barrier function and inflammatory transmitter levels.Methods A total of 84 cases of patients with SAP treated in our hospital from October 2015 to October 2017 were selected as objects and randomly divided into the control group and the observation group, with 42 cases in each group.The control group was given conventional symptomatic support, and the observation group was given Esomeprazole combined with SS on the basis of the control group. The symptom indicators, overall treatment effects, intestinal mucosal barrier function and inflammatory transmitter levels were compared between the two groups after treatment. Results After treatment, the relief time of abdominal pain and abdominal distension, the exhaust recovery time and the serum amylase recovery time in the observation group were significantly shorter than those in the control group, and the differences were statistically significant（P〈0.05）. The rate of total clinical effective in the observation group was significantly higher than that in the control group, and the difference was statistically significant（P〈0.05）. The levels of Dlactic acid, DAO, endotoxin and L/M in the two groups after treatment were lower than those before treatment, and the differences were statistically significant（P〈0.05）. The levels of D-lactic acid, DAO, endotoxin and L/M in the observation group after treatment were lower than those in the control group, and the differences were statistically significant（P〈0.05）. The levels of IL-6, IL-8, CRP, and TNF-α in the two groups after treatment were lower than those before treatment, and the differences were statistically significant（P〈0.05）. The levels of IL-6, IL-8, CRP, and TNF-α in the observation group after treatment were lower than those in the control group, and the differences were statistically significant（P〈0.05）. Conclusion Esomeprazole combined with SS for SAP can improve the symptoms and the treatment effective rate, promote the recovery of intestinal mucosal barrier function and reduce the levels of inflammatory mediators, which is worthy of clinical application.