清胰汤治疗重症胰腺炎疗效及对炎症因子的影响
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摘要
目的:探究清胰汤治疗重症胰腺炎临床疗效及对炎症因子的影响。方法 :选取2014年1月至2017年6月诊断为急性重症胰腺炎的104例住院患者,按照随机数字表法分成治疗组和对照组各52例。所有患者均予常规治疗。治疗组在常规治疗的基础上,予清胰汤鼻饲。比较两组中医证候评分、急性生理与慢性健康评分(APACHEⅡ评分)、炎症指标和安全指标。结果:两组治疗1周后中医证候积分均较治疗前显著降低,差异有统计学意义(P<0.05),且治疗组治疗后腹痛、口干口渴和恶心呕吐的中医证候评分显著低于对照组,差异有统计学意义(P<0.05)。治疗后两组APACHEⅡ评分均较治疗前显著降低,且治疗组治疗后的APACHEⅡ评分显著低于对照组,差异均有统计学意义(P<0.05)。治疗后两组血白细胞(WBC)和白细胞介素-6(IL-6)均较治疗前显著下降,治疗后的IL-2较治疗前显著升高,且治疗组治疗后WBC和IL-6显著低于对照组,治疗组治疗后的IL-2显著高于对照组,差异均有统计学意义(P<0.05)。两组治疗后的不良反应比较差异无统计学意义(P> 0.05)。结论:清胰汤能有效改善重症胰腺炎的中医证候评分,降低重症胰腺炎的炎症因子。
Objective:To assess the effect of Qingyi decoction for severe acute pancreatitis and its influence on inflammatory factors. Methods:A total of 104 patients with severe acute pancreatitis in our hospital from January 2014 to June 2017 were randomly divided into treatment group and control group,52 patients in each group. The patients in control group were given conventional therapy,and the patients in treatment group was treated with conventional treatments and Qingyi decoction through nasogastric gavage. Traditional Chinese medicine(TCM) symptom score,acute physiology and chronic health evaluation(APACHE) Ⅱ score,inflammatory factors and safety indexes were compared between two groups. Results:After 1-week treatment,TCM symptom scores in both group were significantly decreased after treatment(P<0.05),and TCM symptom scores of abdominal pain,xerostomia and vomiting in the treatment group were significantly lower than those in the control group(P<0.05). APACHE Ⅱ scores in two group were also significantly decreased after1-week treatment(P<0.05),and the APACHE Ⅱscore in treatment group were significantly lower than that in the control group(P<0.05). White blood cell(WBC) count and inter interleukin(IL)-6 level were also significantly decreased after 1-week treatment(P<0.05),and the WBC count and IL-6 level in treatment group were significantly lower than those in the control group(P<0.05). IL-2 level was increased after 1-week treatment(P<0.05),and IL-2 level in the treatment group were significantly high than that in the control group(P<0.05). But on the safety indexes there was no significant difference between both groups(P> 0.05). Conclusion:Qingyi decoction can reduce the clinical symptom and decrease the inflammatory factors in the patients with severe acute pancreatitis.
Objective:To assess the effect of Qingyi decoction for severe acute pancreatitis and its influence on inflammatory factors. Methods:A total of 104 patients with severe acute pancreatitis in our hospital from January 2014 to June 2017 were randomly divided into treatment group and control group,52 patients in each group. The patients in control group were given conventional therapy,and the patients in treatment group was treated with conventional treatments and Qingyi decoction through nasogastric gavage. Traditional Chinese medicine(TCM) symptom score,acute physiology and chronic health evaluation(APACHE) Ⅱ score,inflammatory factors and safety indexes were compared between two groups. Results:After 1-week treatment,TCM symptom scores in both group were significantly decreased after treatment(P<0.05),and TCM symptom scores of abdominal pain,xerostomia and vomiting in the treatment group were significantly lower than those in the control group(P<0.05). APACHE Ⅱ scores in two group were also significantly decreased after1-week treatment(P<0.05),and the APACHE Ⅱscore in treatment group were significantly lower than that in the control group(P<0.05). White blood cell(WBC) count and inter interleukin(IL)-6 level were also significantly decreased after 1-week treatment(P<0.05),and the WBC count and IL-6 level in treatment group were significantly lower than those in the control group(P<0.05). IL-2 level was increased after 1-week treatment(P<0.05),and IL-2 level in the treatment group were significantly high than that in the control group(P<0.05). But on the safety indexes there was no significant difference between both groups(P> 0.05). Conclusion:Qingyi decoction can reduce the clinical symptom and decrease the inflammatory factors in the patients with severe acute pancreatitis.
引文
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[17]梁淋渊,甘麦邻,罗燕.大黄化学成分与药理活性研究进展[J].中兽医医药杂志,2017,46(1):80-83.
[18]王维琪.黄连有效成分的药理研究与进展[J].中医临床研究,2016,8(26):147-148.
[19]李乃谦.探讨白芍的药理作用及现代研究进展[J].中医临床研究,2017,9(20):137-138.
[20]杨波,纪宏宇,郑东友,等.中药延胡索的炮制工艺和药理作用的研究进展[J].药学实践杂志,2017,35(2):112-115.
[21]蒋丽丽,张彦龙,王春杰,等.牡丹皮中有效成分丹皮酚的药理活性研究进展[J].现代诊断与治疗,2016,27(22):4223-4224.
[2]王红波.生长抑素联合埃索美拉唑对高龄重症胰腺炎患者腹内高压及肠道黏膜屏障功能的影响[J].河南医学研究,2017,26(14):2608-2609.
[3]磨庆福.重症急性胰腺炎的发病原因及发病机制研究进展[J].胃肠病学和肝病学杂志,2014,23(9):1107-1110.
[4]CHARLESWORTH A,STEGER A,CROOK M A.Acute pancreatitis associated with severe hypertriglyceridaemia;A retrospective cohort study[J].Int J Surg,2015,23(Pt A):23-27.
[5]宋月娟,冯强生,哈小琴.重症胰腺炎感染患者病原微生物分布及耐药分析[J].中国卫生检验杂志,2017,27(2):283-285.
[6]杨卫军,杜吉义,吴正阳,等.重症急性胰腺炎患者继发胰腺感染特点及危险因素分析[J].中华医院感染学杂志,2017,27(19):4453-4456.
[7]MAHESHWARI R,SUBRAMANIAN R M.Severe acute pancreatitis and necrotizing pancreatitis[J].Crit Care Clin,2016,32(2):279-290.
[8]翟宏军,张心武,孙晓力,等.重症急性胰腺炎患者血清炎性因子含量与全身靶器官损伤的关系研究[J].海南医学院学报,2017,23(14):1892-1895.
[9]肖青川,兰天罡,兑丹华.清胰Ⅱ号颗粒剂对急性重症胰腺炎大鼠胰腺损伤的保护作用[J].世界中医药,2017,12(4):875-878.
[10]张晓芹,贾晓云,李涛,等.清胰汤对L-精氨酸诱发的重症急性胰腺炎小鼠胰腺p-STAT3表达的影响[J].中国病理生理杂志,2011,27(11):2175-2179.
[11]中华医学会外科学分会胰腺外科学组.急性胰腺炎诊治指南(2014)[J].中华外科杂志,2015,53(1):50-53.
[12]彭卓,万林,张瑞,等.清胰汤辅助治疗急性重症胰腺炎的疗效[J].世界中医药,2017,12(9):2058-2061.
[13]崔云峰,屈振亮,齐清会,等.重症急性胰腺炎中西医结合诊治指南(2014年,天津)[J].中国中西医结合外科杂志,2014,31(4):460-464.
[14]肖瑜,马秀芝,单隽.自拟大承气方剂辅助西医治疗对急性重症胰腺炎患者氧化应激及炎症反应的影响[J]现代中西医结合杂志,2017,26(13):1438-1441.
[15]郑传彬,刘冬厚.大柴胡汤合薏仁败酱汤联合西医疗法治疗重症急性胰腺炎临床研究[J].新中医,2017,49(8):49-51.
[16]刘瑞林,张嘉,吴薇,等.大黄素对肠缺血/再灌注损害保护作用的实验研究[J].中国中西医结合急救杂志,2008,15(1):45-47.
[17]梁淋渊,甘麦邻,罗燕.大黄化学成分与药理活性研究进展[J].中兽医医药杂志,2017,46(1):80-83.
[18]王维琪.黄连有效成分的药理研究与进展[J].中医临床研究,2016,8(26):147-148.
[19]李乃谦.探讨白芍的药理作用及现代研究进展[J].中医临床研究,2017,9(20):137-138.
[20]杨波,纪宏宇,郑东友,等.中药延胡索的炮制工艺和药理作用的研究进展[J].药学实践杂志,2017,35(2):112-115.
[21]蒋丽丽,张彦龙,王春杰,等.牡丹皮中有效成分丹皮酚的药理活性研究进展[J].现代诊断与治疗,2016,27(22):4223-4224.
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