摘要
目的探讨复方嗜酸乳杆菌片联合依达拉奉对重症急性胰腺炎患者的临床效果。方法选取河南科技大学第一附属医院收治的172例重症急性胰腺炎患者,利用随机数字表法将其分为甲、乙、丙与丁4组,各43例。4组均接受常规综合治疗,乙组另接受依达拉奉治疗,丙组另接受复方嗜酸乳杆菌片治疗,丁组另接受复方嗜酸乳杆菌片联合依达拉奉治疗。对比治疗前后肠道菌群和肠黏膜屏障功能相关指标、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)及住院时间、并发症、病死率。结果4组双歧杆属、乳酸杆菌属相对丰度在治疗前、治疗7 d及14 d后均依次升高(P<0.05),丙组、丁组治疗7、14 d后均高于甲组、乙组(P<0.05),丁组治疗7、14 d后高于丙组(P<0.05);4组肠杆菌属、葡萄球菌属、肠球菌属相对丰度在治疗前、治疗7 d及14 d后均依次降低(P<0.05),丙组、丁组治疗7、14 d后均低于甲组、乙组(P<0.05),丁组治疗7、14 d后低于丙组(P<0.05);4组D-乳酸、内毒素、二胺氧化酶(DAO)水平在治疗前、治疗7 d及14 d后均依次降低(P<0.05),乙组、丙组、丁组治疗7、14 d后均低于甲组(P<0.05),乙组、丁组治疗7、14 d后均低于丙组(P<0.05),丁组治疗7、14 d后低于乙组(P<0.05);丁组住院时间短于甲组、乙组、丙组(P<0.05),丁组并发症发生率、病死率低于甲组(P<0.05);4组APACHEⅡ评分在治疗前、治疗7及14 d后均依次降低(P<0.05),乙组、丙组、丁组治疗7、14 d后均低于甲组(P<0.05),丁组治疗7、14 d后低于乙组、丙组(P<0.05)。结论在常规综合治疗的基础上接受复方嗜酸乳杆菌片能够调节重症急性胰腺炎患者机体肠道菌群,改善肠黏膜屏障功能,给予依达拉奉可改善肠黏膜屏障功能,二者均可减轻病情,且二者联合可增强对肠黏膜屏障功能的改善作用和对病情的控制作用,还可显著缩短住院时间,减少并发症,改善预后。
Objective To investigate the clinical efficacy of compound lactobacillus acidophilus tablets combined with edaravone in patients with severe acute pancreatitis.Methods A total of 172 patients with severe acute pancreatitis were selected from the First Affiliated Hospital of Henan University of Science and Technology,and they were divided into group A,group B,group C and group D by using random number table,with 43 cases in each group.All four groups were given routine comprehensive treatment,and group B was given edaravone treatment,and group C was given compound lactobacillus acidophilus tablets treatment,and group D was given compound lactobacillus acidophilus tablets combined with edaravone treatment.The intestinal flora,intestinal mucosal barrier function,acute physiology and chronic health score Ⅱ(APACHEⅡ)before and after treatment and the length of hospital stay,complications and mortality were compared.Results The abundance of bifidobacterium and lactobacillus in the four groups increased successively before treatment,after 7 days and 14 days of treatment(P<0.05),and those in the group C and group D after 7 days and 14 days of treatment were higher than those in the group A and group B(P<0.05),and those in group D after 7 days and 14 days of treatment were higher than group C(P<0.05).The abundance of Enterobacteriaceae,Staphylococcus and Enterococcus in the four groups decreased successively before treatment,after 7 days and 14 days of treatment(P<0.05),and those in the group C and group D after 7 days and 14 days of treatment were lower than those in the group A and group B(P<0.05),and those in group D after 7 days and 14 days of treatment were lower than group C(P<0.05).The levels of D-lactic acid,endotoxin and diamine oxidase(DAO)in the four groups decreased successively before treatment,after 7 days and 14 days of treatment(P<0.05),and those in the group B,group C and group D after 7 days and 14 days of treatment were lower than those in the group A(P<0.05),which group B and group D after 7 days and 14 days of treatment were lower than group C(P<0.05),and those in group D after 7 days and 14 days of treatment were lower than group B(P<0.05).The hospitalization time of group D was shorter than that of group A,B and C(P<0.05),and the incidence rate of complications and mortality in group D were lower than those in group A(P<0.05).The APACHEⅡscores in the four groups decreased successively before treatment,after 7 days and 14 days of treatment(P<0.05),and those in the group B,group C and group D after 7 days and 14 days of treatment were lower than those in the group A(P<0.05),which in group D after 7 days and 14 days of treatment were lower than group B and group C(P<0.05).Conclusion On the basis of routine comprehensive treatment,compound lactobacillus acidophilus tablets can regulate the intestinal flora and improve the intestinal mucosal barrier function of patients with severe acute pancreatitis,and edaravone can improve the intestinal mucosal barrier function,both of which can alleviate the disease,and the combination of the two can enhance the improvement of the intestinal mucosal barrier function and the control of the disease,and it can also significantly shorten the hospital stay,reduce complications and improve the prognosis.
作者
杜力巍
田笑笑
DU Liwei;TIAN Xiaoxiao(Department of Drug Dispensing,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China;Department of Gastroenterology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)
出处
《河南医学研究》
CAS
2024年第1期12-17,共6页
Henan Medical Research
基金
洛阳市2020年度医疗卫生领域指导性科技计划项目(2030005A)。
关键词
复方嗜酸乳杆菌片
依达拉奉
重症急性胰腺炎
肠道菌群
肠黏膜屏障功能
预后
compound lactobacillus acidophilus tablets
edaravone
severe acute pancreatitis
intestinal flora
intestinal mucosal barrier function
prognosis
作者简介
通信作者:田笑笑,E-mail:xxtian1011@163.com。
