柴芍承气汤对重症胰腺炎患者胃肠及凝血功能的影响  

Effect of Chaishao Chengqi Decoction on Gastrointestinal and Blood Coagulation Function in Patients with Severe Acute Pancreatitis

作　　者：孙乐瑾[1] 王华杰[1] 朱永[1] 

机构地区：[1]海南省人民医院重症医学科,海南海口570311

出　　处：《辽宁中医杂志》2017年第9期1870-1873,共4页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的:观察柴芍承气汤对重症胰腺炎患者胃肠及凝血功能的影响。方法:选择2014年1月——2016年11月90例在该院确诊治疗的重症胰腺炎患者,平均分为两组。对照组采用常规治疗,观察组在此基础上加以柴芍承气汤治疗。观察患者微循环指标(胰腺微血管痉挛、微血管内皮细胞损伤、胰腺微血管通透性、血液流变学)、胃肠功能观察指标(腹痛腹胀持续时间、肠鸣音时间、肛门排气、排便恢复时间),检查细胞因子(血清TNF-α、IL-6、IL-8、GMP-140、TXB2、ET-1、血清NO)水平。结果:观察组胰腺微血管痉挛微血管通透性、微血管内皮细胞损伤及血液流变学的改善例数都明显高于对照组(P<0.05)。治疗后两组NO水平显著升高(P<0.05),观察组显著大于对照组;ET-1、TXB2、GMP-140水平显著降低;观察组明显低于对照组(P<0.05)。两组经治疗后TNF-α、IL-6、IL-8水平明显降低(P<0.05),观察组明显低于对照组(P<0.05)。观察组腹痛、腹胀持续时间、肠鸣音时间、肛门排气、排便恢复时间明显短于对照组(P<0.05)。结论:柴芍承气汤能抑制炎症反应,改善血管通透性、胰腺缺血和微循环,恢复重症胰腺炎患者胃肠运动功能。Objective： To observe the effect of Chaishao Chengqi Decoction on gastrointestinal and blood coagulation function in patients with severe acute pancreatitis. Methods： From January 2014 to November 2016,90 patients with severe acute pancreatitis treated in our hospital were divided into two groups. The control group received routine treatment and the observation group on the basis added Chaishao Chengqi Decoction. Observe microcirculation index（ patients with pancreatic microvascular spasm,microvascular endothelial cell injury,pancreatic microvascular permeability and blood rheology）,gastrointestinal function indexes（ abdominal pain duration,the time of bowel sounds,anal exhaust and defecation time,recovery） examination of cytokines（ serum TNF-alpha,IL-6,IL-8 TXB2,GMP-140,ET-1,NO） levels in serum. Results： The microvascular permeability,microvascular endothelial cell damage and blood rheology in the observation group were significantly higher than those in the control group（ P〈0. 05）. After treatment,the levels of NO in two groups were significantly higher（ P〈0. 05） and the observation group＇s was significantly higher than the control group＇s. ET-1,TXB2 and GMP-140 levels were significantly lower. The observation group＇s was significantly lower than that of the control group（ P〈0. 05）. After treatment,the levels of IL-8,IL-6 and TNF-were significantly decreased in the two groups（ P〈0. 05） and the observation group＇ s was significantly lower than that of the control group（ P〈0. 05）. The observation group＇s duration of abdominal pain and abdominal distention,bowel sound recovery time,anal exhaust and defecation time were significantly shorter than those of the control group（ P〈0. 05）. Conclusion： Chaishao Chengqi Decoction can inhibit the inflammatory reaction and improve vascular permeability,pancreatic ischemia and microcirculation to restore the function of gastrointestinal motility in patients with severe pancreatitis.

关 键 词：柴芍承气汤 重症胰腺炎 胃肠功能 凝血功能 

分 类 号：R576[医药卫生—消化系统]