柴芍承气汤对重症急性胰腺炎患者炎症介质的影响  

Effect of chai shao cheng qi decoction on serum inflammation mediators in patients with severe acute pancreatitis

作　　者：凌颖[1] 陈劲松[2] 曹丽鹏[3] 冯志松[1] 

机构地区：[1]川北医学院附属医院消化内科,四川南充637000 [2]潢川县人民医院消化内科,河南潢川465150 [3]遂宁市中心医院消化内科,四川遂宁629000

出　　处：《中国中西医结合急救杂志》2013年第3期138-141,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：四川省医药卫生科研基金资助项目（050062）

摘　　要：目的探讨中药柴芍承气汤治疗重症急性胰腺炎（SAP）的作用机制。方法选择本院住院治疗的SAP患者30例，按随机数字表法分西医常规治疗组和加用柴芍承气汤中西医结合治疗组，每组15例。另以同期10例健康志愿者为健康对照组。采用双抗体夹心卵白素-生物素-过氧化物酶（ABC）-酶联免疫吸附试验（ELISA）测定患者于入院时及治疗3、5、7d血清白细胞介素（IL-6、IL-15）、巨噬细胞抑制因子（MIF）的含量，观察患者腹痛、腹胀、腹部压痛缓解、肠鸣音恢复时间及死亡情况。结果入院时两个治疗组SAP患者血清IL-6、IL-15、MIF浓度均显著高于健康对照组（均P〈0．05）；随治疗时间延长，上述指标呈下降趋势，以中西医结合组下降明显，并于治疗7d时达谷值，且与西医组同期比较差异有统计学意义[IL-6（ng／L）：246．34±86．65比724．88±110．89，IL-15（ng／L）：158．81±50．63比403．04±134．83，MIF（ng／L）：121．90±29．48比240．60±67．36，均P〈0．05]。中西医结合组肠道功能恢复时间较西医组显著缩短[腹痛缓解时间（h）：95．87±32．56比149．33±35．89，腹胀缓解时间（h）：137．07±41．67比191．87±32．08，腹部压痛缓解时间（h）：128．93±40．60比189．73±33．31，肠鸣音恢复时间（h）：88．53±31．71比128．00±30．92，均P〈0．05]。西医组死亡2例，中西医结合组无死亡，但两组比较差异无统计学意义（P〉O．05）。结论中药柴芍承气汤结合常规西医方法治疗SAP疗效优于单纯西医治疗，其作用机制可能与降低血清IL-6、IL-15和MIF水平有关。Objective To investigate the effect of chai shao cheng qi decoction on inflammation mediators in patients with severe acute pancreatitis （SAP）. Methods Thirty patients with SAP were randomly divided into two groups, western medicine group and integrative traditional Chinese medicine （TCM） and western medicine therapy group. Ten healthy volunteers were enrolled in the healthy control group. Double-antibody sandwich avidin- biotin-peroxisome complex （ABC）-enzyme-linked immunosorbent assay （ELISA）was used to detect the levels of serum interleukin-6 （IL-6）, interleukin- 15 （IL- 15 ） and macrophage migration inhibitory factor （MIF） at the time of admission and after admission 3,5 and 7 days. The times of local symptom relief of abdominal pain, distension and abdominal tenderness, bowel sound recovery and death were observed. Results The serum concentrations of IL-6, IL-15 and MIF of two treatment groups at the time of admission were significantly higher than those in healthy control group （all P〈 0.05 ）, but there were no significant differences between the two groups （P 〉 0.05 ）. With the prolongation of treatment, the serum levels of above indexes were all reduced after treatment in two groups, the lowest levels being at the time point 7th day in both groups and compared at all the same time points the levels in integrative medicine therapy group being lower than those in western medicine group [ IL-6 （rig/L） ： 246.34 ＋ 86.65 vs. 724.88 ＋ 110.89, IL-15 （ng/L） ： 158.81 ＋50.63 vs. 403.04＋ 134.83, MIF （ng/L） ： 121.90＋29.48 vs. 240.60＋67.36, all P〈0.05]. The serum concentrations of MIF in integrative medicine therapy group were significantly lower than those in western medicine group after admission 5 days and 7 days （both P〈 0.05 ） . The recovery times of intestinal tract functions in integrative medicine therapy group were much shorter than those in western medicine group [ local symptom relief of abdominal pain （hour） ： 95.87 ＋ 32.5

关 键 词：急性胰腺炎 重症 中西医结合疗法 白细胞介素-6 白细胞介素-15 巨噬细胞抑制因子 柴芍承气汤 

分 类 号：R657.51[医药卫生—外科学]