血塞通联合非洛贝特治疗急性脂源性胰腺炎的多中心随机对照单盲研究  

Multicenter,Randomized,Controlled,Single-blind Study on Acute Lipogenic Pancreatitis Treated by Combination of Xuesaitong Injection and Fenofibrate

作　　者：梁艺钟 姜小艳[1] 张竞超[2] 郭少举 LIANG Yi-Zhong;JIANG Xiao-Yan;ZHANG Jing-Chao;GUO Shao-Ju(The Fourth Clinical Medical College,Guangzhou University of Chinese Medicine,Shenzhen 518033 Guangdong,China;Dept,of Spleen-stomach Disease,Shenzhen Traditional Chinese Medicine Hospittil,Shenzhen 518033 Guangdong,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院脾胃病科,广东深圳518033

出　　处：《广州中医药大学学报》2019年第6期771-776,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(编号:81703859)

摘　　要：【目的】观察血塞通联合非洛贝特治疗急性脂源性胰腺炎患者的临床疗效。【方法】采用多中心随机对照试验,将41例急性脂源性胰腺炎患者随机分为观察组21例和对照组20例。2组患者均给予西医常规治疗(包括基础治疗、血液净化治疗和降血脂治疗等),在此基础上,观察组给予血塞通注射液4 mL+5%葡萄糖注射液250 mL静滴治疗,对照组单纯给予5%葡萄糖注射液250 mL静滴治疗,疗程7 d。观察2组患者治疗前和治疗第3、7天全身炎症指标[C反应蛋白(CRP)和降钙素原(PCT)]、细胞因子[血清肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)和白细胞介素-10(IL-10)]、氧化应激指标[超氧化物歧化酶(SOD)和丙二醛(MAD)]、血脂[甘油三酯(TG)]和炎症性肠病生活质量量表(IBDQ)评分的变化情况。【结果】(1)治疗第3、7天时,2组患者的CRP、PCT水平均较治疗前改善(P<0.05),且在治疗第7天时观察组对PCT水平的改善程度明显优于对照组(P<0.05)。(2)治疗第3天时,2组患者IFN-γ水平均较治疗前改善,治疗第7天时,观察组TNF-α、IFN-γ、IL-10水平和对照组TNF-α、IFN-γ水平较治疗前改善(P<0.05),且在治疗第7天时观察组对TNF-α、IL-10水平的改善作用明显优于对照组(P<0.05)。(3)治疗第3天时,观察组SOD及MAD水平均较治疗前明显改善(P<0.05),对照组SOD水平也较治疗前改善(P<0.05),且观察组对MAD的改善程度优于对照组(P<0.05)。治疗第7天时,2组患者SOD及MAD水平均较治疗前改善,且观察组对SOD和MAD水平的改善程度均明显优于对照组(P<0.05)。(4)治疗第3天时,2组患者TG水平及IBDQ量表评分均未见明显改善(P>0.05);治疗第7天时,2组患者TG水平及IBDQ量表评分均较治疗前明显改善(P<0.05),且观察组在治疗第7天时对IBDQ量表评分的改善程度优于对照组(P<0.05)。【结论】血塞通联合非洛贝特治疗急性脂源性胰腺炎,具有较好疗效,能更好地改善患者的炎症指�Objective To observe the clinical effect of Xuesaitong Injection combined with Fenofibrate for the treatment of patients with acute lipogenic pancreatitis. Methods A multicenter,randomized,controlled,singleblind trial was carried out in 41 patients with acute lipogenic pancreatitis. The patients were divided into observation group(21 cases)and control group(20 cases),and all of them were treated with conventional western medicine therapy such as basic treatment,blood purification,and lipid-lowering treatment. And additionally,the observation group was given intravenous dripping of 4 mL of Xuesaitong Injection plus 250 mL of 5% Glucose Injection,and the control group was only given 250 mL of 5% Glucose Injection. The treatment for the two groups covered 7 days. Before treatment and on treatment day 3 and 7,we observed the levels of the general inflammatory indexes such as C-reactive protein(CRP)and procalcitonin(PCT),serum cytokines such as tumor necrosis factor alpha(TNF-α),interferon gamma(IFN-γ)and interleukin 10(IL-10),oxidative stress indicators such as superoxide dismutase(SOD)and malondialdehyde(MDA),blood lipid of triglyceride(TG)and the scores of Inflammatory Bowel Disease Questionnaire(IBDQ). Results(1)On treatment day 3 and 7,the levels of CRP and PCT in the two groups were improved compared with those before treatment(P<0.05),and the improvement in the observation group on treatment day 7 was superior to that in the control group(P<0.05).(2)On treatment day3,IFN-γ level in the two groups was improved compared with that before treatment(P<0.05). On treatment day7,TNF-α,IFN-γ and IL-10 levels in the observation group and TNF-α and IFN-γ levels in the control group were improved compared with those before treatment(P<0.05),and the improvement of TNF-α and IL-10 levels in the observation group on treatment day 7 was superior to that in the control group(P<0.05).(3)On treatment day 3,SOD and MDA levels in the observation group and SOD level in the control group were improved compared with those befo

关 键 词：血塞通 非洛贝特 脂源性胰腺炎 随机对照试验 

分 类 号：R259.76[医药卫生—中西医结合]