乌司他丁联合枯草杆菌二联活菌颗粒治疗急性胰腺炎的效果及对临床症状改善、肠黏膜屏障功能的影响

Effects of Ulinastatin Combined with Bacillus Subtilis Bivalent Viable Granules in the Treatment of AcutePancreatitis and Its Impact on Clinical Symptom Improvements and Intestinal Mucosal Barrier Function

目的 探讨乌司他丁联合枯草杆菌二联活菌颗粒治疗急性胰腺炎的效果及对临床症状改善、肠黏膜屏障功能的影响。方法 选取2020年1月—2021年12月就诊的急性胰腺炎106例,按照治疗方法不同将其分为观察组和对照组2组各53例。观察组给予乌司他丁联合枯草杆菌二联活菌颗粒治疗,对照组给予乌司他丁治疗。比较2组治疗7 d后临床效果,治疗期间临床症状改善时间(腹痛缓解、胰腺消肿、恢复排气及血尿淀粉酶正常时间),治疗前和治疗7 d后血清胰酶水平(淀粉酶、脂肪酶)、肠黏膜屏障功能(内毒素、二胺氧化酶、D-乳酸)、氧化应激水平[一氧化氮(NO)、丙二醛(MDA)和超氧化物歧化酶(SOD)],以及治疗期间不良反应。结果 治疗7 d后,观察组总有效率高于对照组(P<0.05)。治疗期间,观察组各临床症状改善时间均短于对照组(P<0.01)。治疗7 d后,血清胰酶水平、肠黏膜屏障功能及NO、MDA 2组均较治疗前降低,且观察组低于对照组;SOD 2组均较治疗前升高,且观察组高于对照组(P<0.01)。治疗期间,2组均未出现明显不良反应。结论 乌司他丁联合枯草杆菌二联活菌颗粒治疗急性胰腺炎患者效果良好,且能够缓解临床症状,降低血清胰酶水平,改善肠黏膜屏障功能,减轻氧化应激反应。

Objective To explore the effects of Ulinastatin combined with Bacillus Subtilis Bivalent Viable granules in the treatment of acute pancreatitis and its impact on improvements of clinical symptoms and intestinal mucosal barrier function.Methods One hundred and six patients with acute pancreatitis treated in the hospital from January 2020 to December 2021 were selected and divided into observation group(n=53)and control group(n=53)according to different treatment methods.The observation group was given Ulinastatin combined with Bacillus Subtilis Bivalent Viable granules,and the control group was treated with Ulinastatin.The clinical effects at 7 d after treatment,time of clinical symptom improvement(time to abdominal pain relief,time to pancreas detumescence,exhaust recovery time,time to restoration of normal hematuria amylase)during treatment and serum pancreatic enzymes(amylase,lipase),intestinal mucosal barrier function(endotoxin,diamine oxidase,D-lactic acid)and oxidative stress[nitric oxide(NO),malondialdehyde(MDA),superoxide dismutase(SOD)]before treatment and at 7 d after treatment as well as adverse reactions during treatment were compared between the two groups.Results At 7 d after treatment,the total effective rate in observation group was higher than that in control group(P<0.05).During treatment,the time of clinical symptom improvement in observation group was shorter than that in control group(P<0.01).The levels of serum pancreatic enzymes,intestinal mucosal barrier function indicators,NO and MDA at 7 d after treatment were reduced compared with those before treatment,and the above levels in observation group were lower than those in control group;the SOD level in both groups was enhanced compared with that before treatment,and the level was higher in observation group than in control group(P<0.01).During the treatment period,there were no significant adverse reactions in both groups.Conclusion Ulinastatin combined with Bacillus Subtilis Bivalent Viable granules has good effects in the treatment of acute pancreatitis.It can relieve the clinical symptoms,lower the levels of serum pancreatic enzymes,improve intestinal mucosal barrier function,and reduce the oxidative stress response.