异甘草酸镁联合生长抑素治疗重症急性胰腺炎疗效观察

摘要

Objective To investigate the clinical efficacy of magnesium isoglycyrrhizinate combined with somatostatin in the treatment of severe acute pancreatitis (SAP). Methods A total of 114 patients with SAP were selected in Department of Emergency Medicine, the 174th Hospital of Chinese People Liberation Army from July 5, 2015 to August 12, 2017. They were randomly divided into 3 groups, magnesium isoglycyrrhizinate group, somatostatin group and combined group, with 38 patients in each group, which were treated by magnesium isoglycyrrhizinate, somatostatin, and magnesium isoglycyrrhizinate combined with somatostatin treatment, respectively, continuously for 1 week. The therapeutic effect after treatment was evaluated, and the blood samples of all patients were extracted. The levels of high sensitive C-reactive protein (hs-CRP), interleukin-1β(IL-1β), interleukin-6 (IL-6), oxygenation index (OI), alanine aminotransferase (ALT), aspertate aminotransferase (AST) and creatinine (Cr) were tested. Dynamic monitoring of the change of illness, and the abdominal pain relief time, gastrointestinal function recovery time, and ventilator weaning time were recorded. The adverse events were observed. Results The improved rate in the magnesium isoglycyrrhizinate group, somatostatin group were 65.79%, 71.06%, respectively, which were significantly lower than 92.10% in the combined group (P<0.05). Compared with before treatment, the levels of hs-CRP, IL-1β, IL-6, OI, ALT, AST and CR showed a significant decrease after treatment among the 3 groups (P<0.05). Compared with magnesium isoglycyrrhizinate group and somatostatin group, the levels of hs-CRP, IL-1β, IL-6, OI, ALT, AST and CR showed a significant decrease (P<0.05). The abdominal pain relief time, gastrointestinal function recovery time and ventilator weaning time in combined group were significantly lower than those in magnesium isoglycyrrhizinate group and somatostatin group (P<0.05). Conclusion Magnesium isoglycyrrhizinate combined with somatostatin in the treatment of SAP can reduce the level of inflammatory factors, and protect important organ function. It has high safety and definite curative effect, which can be used as a therapeutic scheme.%目的 观察异甘草酸镁联合生长抑素治疗重症急性胰腺炎(SAP)的临床疗效.方法 选取2015年7月5日至2017年8月12日中国人民解放军第一七四医院急诊医学科内科收治的SPA患者114例,按随机数表法分为异甘草酸镁组、生长抑素组及联合组三组,每组38例.异甘草酸镁组采用异甘草酸镁治疗,生长抑素组采用生长抑素治疗,联合组采用异甘草酸镁联合生长抑素治疗,持续用药1周.治疗后评价治疗效果,抽取所有患者的血液样本,测定高敏C反应蛋白(hs-CRP)、白介素-1β(IL-1β)、白介素-6(IL-6)、氧合指数(OI)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酸酐(Cr)数值,动态监测病情变化,记录腹痛缓解时间、胃肠功能恢复时间及撤呼吸机时间,观察不良反应事件.结果 异甘草酸镁组、生长抑素组患者的改善率分别为65.79%、71.06%,明显低于联合组的92.10%,差异有统计学意义(P<0.05);与治疗前比较,三组患者治疗后的血清hs-CRP、IL-1β、IL-6水平均明显降低,OI、ALT、AST、CR水平也均明显降低,差异均有统计学意义(P<0.05);与异甘草酸镁组、生长抑素组比较,联合组治疗后的血清hs-CRP、IL-1β、IL-6水平明显降低,OI、ALT、AST、CR水平也明显降低,差异均有统计学意义(P<0.05);联合组患者在腹痛缓解时间、胃肠功能恢复时间及撤呼吸机时间方面均明显低于异甘草酸镁组和生长抑素组,差异均有统计学意义(P<0.05).结论 异甘草酸镁联合生长抑素治疗SAP能降低患者的炎症因子水平,保护重要脏器功能,安全性高,疗效确切,可以作为一种治疗方案.