艾普拉唑片联合双歧杆菌四联活菌片治疗重症急性胰腺炎的效果及对胃肠功能和胃肠黏膜屏障功能的影响

Effects of ilaprazole combined with Bifidobacterium quadruple viable tablet on patients with severe acute pancreatitis and its influence on gastrointestinal function and gastrointestinal mucosal barrier

目的探讨艾普拉唑片联合双歧杆菌四联活菌片治疗重症急性胰腺炎(SAP)的效果及对患者胃肠功能和胃肠黏膜屏障功能的影响。方法选择2018年1月至2020年1月洛阳市第一人民医收治的SAP患者134例,依据随机数字表法分为观察组和对照组,每组67例。对照组患者给予双歧杆菌四联活菌片治疗,观察组在对照组治疗基础上口服艾普拉唑片治疗,两组疗程均为2周。比较两组疗效,腹痛、血淀粉酶、腹胀和尿淀粉酶恢复时间,治疗前和治疗2周后胃肠功能和胃肠黏膜屏障功能的变化情况。结果观察组总有效率(91.05%,61/67)高于对照组(74.63%,50/67),P<0.05。观察组腹痛、血淀粉酶、腹胀和尿淀粉酶恢复时间少于对照组(P<0.05)。治疗2周后,两组血清胃泌素和血管活性肠肽(VIP)水平较治疗前降低,而胃动素水平较治疗前升高(P<0.05);且观察组血清胃泌素和VIP水平低于对照组,胃动素水平高于对照组(P<0.05)。治疗2周后,两组血清D-乳酸、二胺氧化酶(DAO)和内毒素水平较治疗前降低(P<0.05);且观察组血清血清D-乳酸、DAO和内毒素水平均低于对照组(P均<0.05)。结论艾普拉唑片联合双歧杆菌四联活菌片治疗SAP患者效果明显,且患者胃肠功能和胃肠黏膜屏障功能明显改善。

Objective To investigate the effects of ilaprazole combined with Bifidobacterium quadruple viable tablet on patients with severe acute pancreatitis(SAP)and its influence on gastrointestinal function and gastrointestinal mucosal barrier.Methods A total of 134 SAP patients admitted to the First People’s Hospital of Luoyang from January 2018 to January 2020 were selected,and they were divided into observation group and control group according to the random number table method,with 67 cases in each group.Patients in the control group were treated with Bifidobacterium quadruple viable tablet,while patients in the observation group were treated with ilaprazole tablet based on the treatment of the control group.The course of treatment in both groups was 2 weeks.The efficacy,recovery time of abdominal pain,blood amylase,abdominal distension and urine amylase were compared between the two groups.And the changes of gastrointestinal function and gastrointestinal mucosal barrier function were compared between the two groups before and after 2 weeks of treatment.Results The total effective rate of the observation group(91.05%,61/67)was higher than that of the control group(74.63%,50/67),P<0.05.The recovery time of abdominal pain,blood amylase,abdominal distention and urine amylase in the observation group were shorter than those in the control group(P<0.05).Compared with preoperative levels,the levels of serum gastrin and vasoactive intestinal peptide(VIP)in the two groups were lower 2 weeks after treatment,while the levels of motilin were higher(P<0.05).The levels of serum gastrin and VIP in the observation group were lower than those in the control group,while the levels of motilin were higher than those in the control group 2 weeks after treatment(P<0.05).Compared with preoperative levels,the levels of serum D-lactate,diamine oxidase(DAO)and endotoxin in the two groups decreased 2 weeks after treatment(P<0.05);the levels of serum D-lactate,DAO and endotoxin in the observation group were lower than those in the control group(all P<0.05).Conclusions Ilaprazole combined with Bifidobacterium quadruple viable tablet has a significant therapeutic effect on SAP patients,and the gastrointestinal function and gastrointestinal mucosal barrier function can be significantly improved.