自拟清热解毒祛瘀方联合西药对重症急性胰腺炎患者炎症因子、肠道屏障功能的影响  

Therapeutic Effect of Self-made Qingre Jiedu Quyu Decoction Combined with Western Medicine on SAP and Its Effect on Inflammatory Factors and Intestinal Barrier Function

作　　者：毛峥嵘[1] 冯博[1] 张少雷 朱智琦 何金波[1] Mao Zhengrong;Feng Bo;Zhang Shaolei(First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Henan,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中国中医急症》2019年第3期472-474,482,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题(2018ZY1002)

摘　　要：目的探讨自拟清热解毒祛瘀方联合西药治疗重症急性胰腺炎(SAP)疗效及对炎症因子、肠道屏障功能的影响并探讨其作用机制。方法 118例SAP患者随机分为对照组与观察组各59例。对照组给予乌司他丁+埃索美拉唑+美罗培南方案。观察组在对照组基础上辅以自拟清热解毒祛瘀方治疗。比较两组近期疗效,肠道症状改善时间,治疗前后主要证候评分、白细胞计数(WBC)、血淀粉酶(AMY)、尿淀粉酶、炎症因子及肠道屏障功能指标水平。结果观察组近期疗效总有效率为89.83%,高于对照组的74.58%(P <0.05)。观察组腹痛减轻、腹胀减轻及肠鸣音恢复时间均短于对照组(均P <0.05)。两组治疗前中医证候评分比较,均差别不大(均P> 0.05)。两组治疗后中医证候评分均较治疗前明显下降,且观察组治疗后各中医证候评分均优于对照组(均P <0.05)。两组治疗后WBC计数、AMY、尿淀粉酶、IL-6、TNF-α水平、内毒素、D-乳酸及尿L/M比值水平均较治疗前明显下降,且观察组治疗后WBC计数、AMY、尿淀粉酶、IL-6、IL-10、TNF-α水平、内毒素、D-乳酸及尿L/M比值水平均优于对照组(均P <0.05)。结论自拟清热解毒祛瘀方联合西药治疗SAP能够减轻中医证候表现,缩短病程,改善理化指标,降低机体炎症反应水平,并有助于保护肠道屏障功能。Objective: To investigate the effect of Self-made Qingre Jiedu Quyu Decoction combined with Western medicine on SAP and the effect on inflammatory factors and intestinal barrier function. Methods: 118 SAP patients were randomly divided into the control group and the observation group,59 cases in each. Ulinastatin+Esomeprazole+Meropenem was given to the control group,and on this basis,Self-made Qingre Jiedu Quyu Decoction was supplemented to the the observation group. The short-term efficacy,improvement time of intestinal symptoms,scores of main syndromes,WBC count,blood amylase,urinary amylase,inflammatory factors and intestinal barrier function were compared between the two groups before and after treatment. Results: The short-term curative effect of the observation group was significantly better than that of the control group(P < 0.05),and the time of relieving abdominal pain,abdominal distension and recovery of bowel sounds was significantly shorter than that in the control group(P < 0.05). After treatment,the scores of main syndromes in the observation group were significantly lower than those in the control group and before treatment(P < 0.05);WBC count,blood amylase,urinary amylase and levels of IL-6 and TNF-α were significantly higher than those in the control group and before treatment(P < 0.05). Conclusion: Self-made Qingre Jiedu Quyu Decoction combined with Western medicine on SAP can alleviate the related TCM symptoms,shorten the time for rehabilitation,improve physical and chemical indicators,reduce the level of inflammatory response,and help to protect the intestinal barrier function.

关 键 词：重症急性胰腺炎 自拟清热解毒祛瘀方 西药 炎症因子 肠道屏障功能 

分 类 号：R576[医药卫生—消化系统]