【摘要】 目的:观察通腑化瘀汤联合微生态制剂对重症急性胰腺炎(severe acute pancreatitis, SAP)患者肠道黏膜屏障及胃肠动力的影响。方法:使用前瞻性随机对照试验的方法，连续纳入2020年3月-2022年2月收治的90例SAP患者作为研究对象，按照随机数字表法分为实验组和对照组，每组各45例。对照组接受一般治疗和微生态制剂治疗，实验组在对照组基础上服用通腑化瘀汤，以治疗7 d为疗效评价时点。观察指标为肠道黏膜屏障(内毒素、二胺氧化酶、乳酸水平)和胃肠动力(胃动素、血管活性肠肽、胆囊收缩素水平)。结果:治疗期间实验组和对照组分别被剔除2例和3例，最终实验组43例、对照组42例完成本研究。两组治疗总有效率比较，差异无统计学意义(P>0.05);实验组临床痊愈率、显效率高于对照组，差异有统计学意义(P<0.05)。两组治疗后内毒素、乳酸、二胺氧化酶水平比治疗前均降低，实验组均低于对照组，差异有统计学意义(P<0.05)。两组治疗后胃动素、胆囊收缩素水平比治疗前升高，血管活性肠肽水平比治疗前降低，实验组胃动素、胆囊收缩素水平高于对照组，血管活性肠肽水平低于对照组，差异有统计学意义(P<0.05)。结论:通腑化瘀汤联合微生态制剂治疗SAP,能够促进患者肠道黏膜屏障功能恢复，改善胃肠动力，有助于提高疾病治愈率。更多还原

【Abstract】 Objective: To observe the effect of Tongfu Huayu Decoction combined with microecological preparation on intestinal mucosal barrier and gastrointestinal motility in patients with severe acute pancreatitis(SAP). Methods: A prospective randomized controlled trial was used. Ninty patients with SAP who were admitted from March 2020 to February 2022 were enrolled in the study. They were divided into test group and control group according to the random number table, with 45 patients in each group. The control group received general treatment+microecological preparation treatment, and the test group took Tongfu Huayu Decoction on the basis of the control group. The therapeutic effect was evaluated at seven days. The intestinal mucosal barrier(Endotoxin, diamine oxidase[DAO], lactic acid[Lac])and gastrointestinal motility(motilin[MTL], vasoactive intestinal peptide[VIP], cholecystokinin[CCK]) were observed. Results: During the treatment, two cases in the test group and three cases in the control group were excluded, 43 cases in the final test group and 42 cases in the control group completed the test. There was no statistical significant difference in the total effective rate between the two groups(P>0.05). The clinical recovery rate and significant effectiveness rate of the test group are higher than those of the control group, with a statistical significant difference(P<0.05). The levels of Endotoxin, Lac, and DAO in the two groups after treatment were lower than those before treatment, and the level of the test group was lower than that in the control group, with a statistical significant difference(P<0.05). After treatment, the levels of MTL and CCK in the two groups were higher than those before treatment, and the level of VIP was lower than that before treatment. The levels of MTL and CCK in the test group were higher than those in the control group, and the level of VIP was lower than that in the control group, with a statistical significant difference(P<0.05). Conclusion: Tongfu Huayu Decoction combined with microecological preparation can promote the recovery of intestinal mucosal barrier function, improve gastrointestinal motility and improve the cure rate of SAP patients.更多还原