双歧杆菌四联活菌片联合早期肠内营养在重症急性胰腺炎患者中的应用效果

Application of Bifidobacterium quadruple viable bacteria tablets combined with early enteral nutrition in patients with severe acute pancreatitis

目的探讨双歧杆菌四联活菌片联合早期肠内营养应用于重症急性胰腺炎(AP)患者中的临床效果。方法前瞻性对照研究。抽取2022年4月至2023年4月商丘市第一人民医院收治的100例重症AP患者100例,根据随机数字表法分为对照组和观察组,每组50例。两组患者均接受常规治疗,对照组接受早期肠内营养治疗,观察组在对照组治疗方案的基础上联合使用双歧杆菌四联活菌片进行治疗,两组患者均治疗2周。比较两组临床疗效,比较两组治疗前后肠黏膜功能[内毒素(ET)、D-乳酸(D-lac)、二胺氧化酶(DAO)、尿乳果糖/甘露醇(L/M值)]及免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))。结果观察组治疗总有效率(98.00%,49/50)高于对照组(84.00%,42/50),P<0.05。治疗后,两组D-lac、DAO、ET、L/M值均较治疗前下降,且观察组上述各指标水平均低于对照组(P均<0.05);两组患者CD3^(+)、CD4^(+)/CD8^(+)、CD4^(+)均较治疗前上升,且观察组高于对照组(P<0.05);两组CD8^(+)较治疗前降低,且观察组CD8^(+)水平低于对照组(P<0.05)。结论将双歧杆菌四联活菌与早期肠内营养联合应用于重症AP患者中,可改善患者肠黏膜功能,提升免疫力,提高整体疗效。

Objective To investigate the clinical efficacy of the combination of Bifidobacterium quadruple viable bacteria tablets combined with early enteral nutrition in the treatment of patients with severe acute pancreatitis(AP).Methods The study was a prospective controlled trial.A total of 100 severe AP patients admitted to the First People’s Hospital of Shangqiu from April 2022 to April 2023 were selected,and they were divided into a control group and an observation group using a random number table method,with 50 cases in each group.Both groups received routine treatment.Additionally,the control group received early enteral nutrition treatment,and the observation group was treated with Bifidobacterium quadruple viable bacteria tablets based on the treatment of the control group.Both groups were treated for two weeks.The clinical efficacy of the two groups were compared.The intestinal mucosal function,evaluated by endotoxin(ET),D-lactic acid(D-lac),diamine oxidase(DAO),urinary lactulose/mannitol(L/M value),and immune function indicators,including cluster of differentiation 3^(+)(CD3^(+)),cluster of differentiation 4^(+)(CD4^(+)),cluster of differentiation 8^(+)(CD8^(+))and CD4^(+)/CD8^(+),of the two groups were compared before and after treatment.Results The total effective rate in the observation group(98.00%,49/50)was higher than that in the control group(84.00%,42/50),P<0.05.After treatment,the D-lac,DAO,ET and L/M values in both groups decreased compared with these indexes before treatment,and the levels of the above indicators in the observation group were lower than those in the control group(all P<0.05).After treatment,the levels of CD3^(+),CD4^(+)/CD8^(+),and CD4^(+)in both groups increased compared with levels before treatment,and the above indexes in the observation group were higher compared with the control group(all P<0.05).After treatment,CD8^(+)in both groups decreased,and the CD8^(+)level in the observation group was lower than that in the control group(P<0.05).Conclusions Bifidobacterium quadruple viable bacteria tablets combined with early enteral nutrition,in the treatment of patients with severe AP,can better improve intestinal mucosae function,enhance immunity,and improve overall treatment efficacy.