参麦注射液联合肠内营养治疗高脂血症性重症急性胰腺炎的临床研究(1)
[摘要] 目的 探讨参麦注射液联合肠内营养治疗高脂血症性重症急性胰腺炎(HLSAP)的效果及安全性。 方法 选择2016年1月～2018年6月云南省第三人民医院收治的93例HLSAP患者，按照随机数字表法分为观察组(47例)和对照组(46例)。对照组给予肠内营养治疗，观察组给予参麦注射液联合肠内营养治疗，两组均连续治疗14 d。比较两组临床疗效，评价并比较两组治疗前后的急性生理及慢性健康状况评分Ⅱ(APACHEⅡ)评分、Balthazar CT评分，检测并比较两组治疗前后血清前清蛋白(PAB)、血清蛋白(ALB)、三酰甘油(TG)、C反应蛋白(CRP)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)及免疫球蛋白G(IgG)水平。记录两组治疗过程中不良反应的发生情况。结果 观察组的临床总有效率为97.87%(46/47)，明显高于对照组的78.26%(36/46)，差异有统计学意义(χ2 = 8.573，P = 0.003)。治疗后，两组APACHEⅡ评分、Balthazar CT评分均明顯低于治疗前(P < 0.05)，且观察组低于对照组(P < 0.05)。治疗后，两组血清PAB、ALB、IgA、IgM及IgG水平均明显高于治疗前(P < 0.05)，血清TG、CRP水平均明显低于治疗前(P < 0.05)，同时观察组治疗后血清PAB、ALB、TG、CRP、IgA、IgM及IgG水平改善程度明显优于对照组(P < 0.05)。两组治疗过程中均未发现严重的不良反应。 结论 参麦注射液联合肠内营养治疗HLSAP的临床效果显著，能够明显改善营养状况，减轻炎性反应，增强免疫功能，且安全性较好。
[关键词] 参麦注射液;肠内营养;高脂血症性重症急性胰腺炎;疗效;安全性
[中图分类号] R576 [文献标识码] A [文章编号] 1673-7210(2019)10(b)-0136-05
Clinical study of Shenmai Injection combined with enteral nutrition in the treatment of hyperlipidemic severe acute pancreatitis
WANG Jian′gang1 WANG Yubo2 KONG Na1
1.Department of Gastroenterology， the Third People′s Hospital of Yunnan， Yunnan Province， Kunming 650011， China; 2.Department of Clinical Nutrition， the Third People′s Hospital of Yunnan， Yunnan Province， Kunming 650011， China
[Abstract] Objective To investigate the efficacy and safety of Shenmai Injection combined with enteral nutrition in the treatment of hyper lipidemic severe acute pancreatitis (HLSAP). Methods Ninety-three patients with HLSAP admitted to the Third People′s Hospital of Yunnan from January 2016 to June 2018 were selected. According to the random number table method， the patients were divided into observation group (47 cases) and control group (46 cases). The control group was treated with enteral nutrition， the observation group was treated with Shenmai Injection combined with enteral nutrition. Both groups were treated continuously for 14 days. The clinical effect of the two groups was compared. The acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and Balthazar CT score were evaluated and compared between the two groups before and after treatment. The levels of serum prealbumin (PAB)， albumin (ALB)， triacylglycerol (TG)， C-reactive protein (CRP)， immunoglobulin A (IgA)， immunoglobulin M (IgM) and immunoglobulin G (IgG) were detected and compared between the two groups before and after treatment. The occurrence of adverse reactions during the treatment was recorded. Results The total clinical effective rate of the observation group was 97.87% (46/47)， which was significantly higher than 78.26% (36/46) of the control group， the difference was statistically significant (χ2 = 8.573， P = 0.003). After treatment， APACHEⅡ and Balthazar CT scores of the two groups were significantly lower than those before treatment (P < 0.05)， which of the observation group were lower than the control group (P < 0.05). After treatment， the serum levels of PAB， ALB， IgA， IgM and IgG in the two groups were significantly higher than those before treatment (P < 0.05)， the serum levels of TG and CRP were significantly lower than those before treatment (P < 0.05)， and the improvement of serum levels of PAB， ALB， TG， CRP， IgA， IgM and IgG in the observation group was significantly better than those in the control group (P < 0.05). No serious adverse reactions were found during the treatment in both groups. Conclusion Shenmai Injection combined with enteral nutrition in the treatment of HLSAP has significant clinical efficacy， which can significantly improve the nutritional status， reduce inflammatory reaction， enhance immune function， and has good security., 百拇医药(王建刚 王玉波 孔娜)
[关键词] 参麦注射液;肠内营养;高脂血症性重症急性胰腺炎;疗效;安全性
[中图分类号] R576 [文献标识码] A [文章编号] 1673-7210(2019)10(b)-0136-05
Clinical study of Shenmai Injection combined with enteral nutrition in the treatment of hyperlipidemic severe acute pancreatitis
WANG Jian′gang1 WANG Yubo2 KONG Na1
1.Department of Gastroenterology， the Third People′s Hospital of Yunnan， Yunnan Province， Kunming 650011， China; 2.Department of Clinical Nutrition， the Third People′s Hospital of Yunnan， Yunnan Province， Kunming 650011， China
[Abstract] Objective To investigate the efficacy and safety of Shenmai Injection combined with enteral nutrition in the treatment of hyper lipidemic severe acute pancreatitis (HLSAP). Methods Ninety-three patients with HLSAP admitted to the Third People′s Hospital of Yunnan from January 2016 to June 2018 were selected. According to the random number table method， the patients were divided into observation group (47 cases) and control group (46 cases). The control group was treated with enteral nutrition， the observation group was treated with Shenmai Injection combined with enteral nutrition. Both groups were treated continuously for 14 days. The clinical effect of the two groups was compared. The acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and Balthazar CT score were evaluated and compared between the two groups before and after treatment. The levels of serum prealbumin (PAB)， albumin (ALB)， triacylglycerol (TG)， C-reactive protein (CRP)， immunoglobulin A (IgA)， immunoglobulin M (IgM) and immunoglobulin G (IgG) were detected and compared between the two groups before and after treatment. The occurrence of adverse reactions during the treatment was recorded. Results The total clinical effective rate of the observation group was 97.87% (46/47)， which was significantly higher than 78.26% (36/46) of the control group， the difference was statistically significant (χ2 = 8.573， P = 0.003). After treatment， APACHEⅡ and Balthazar CT scores of the two groups were significantly lower than those before treatment (P < 0.05)， which of the observation group were lower than the control group (P < 0.05). After treatment， the serum levels of PAB， ALB， IgA， IgM and IgG in the two groups were significantly higher than those before treatment (P < 0.05)， the serum levels of TG and CRP were significantly lower than those before treatment (P < 0.05)， and the improvement of serum levels of PAB， ALB， TG， CRP， IgA， IgM and IgG in the observation group was significantly better than those in the control group (P < 0.05). No serious adverse reactions were found during the treatment in both groups. Conclusion Shenmai Injection combined with enteral nutrition in the treatment of HLSAP has significant clinical efficacy， which can significantly improve the nutritional status， reduce inflammatory reaction， enhance immune function， and has good security., 百拇医药(王建刚 王玉波 孔娜)