"郭氏六联疗法"治疗急性胰腺炎肠黏膜屏障功能障碍临床研究  

Clinical study of Guo's Liulian therapy in the treatment of intestinal mucosal barrier dysfunction in acute pancreatitis

作　　者：陈英杰 张宏伟 蔡喆 张幼妮 陈晓萍 王真凉 郭森仁 庄耀东 Chen Yingjie;Zhang Hongwei;Cai Zhe;Zhang Youni;Chen Xiaoping;Wang Zhenliang;Guo Senren;Zhuang Yaodong(Department of Intensive Care Unit,Jinjiang Hospital of Traditional Chinese Medicine,Jinjiang 362200,China)

机构地区：[1]福建省晋江市中医院重症医学科,362200

出　　处：《国际中医中药杂志》2019年第9期916-920,共5页International Journal of Traditional Chinese Medicine

基　　金：福建省卫生计生委中医药科研课题(2017FJZYLC105);郭森仁全国基层名老中医药专家传承工作室建设项目(国中医药人教发〔2016〕41号);福建中医药大学附属晋江中医院研究课题(YN201703)。

摘　　要：目的探讨"郭氏六联疗法"治疗急性胰腺炎(acute pancreatitis,AP)肠黏膜屏障功能障碍的疗效.方法将符合入选标准的68例AP患者按随机数字表法分为2组,每组34例.对照组给予西医常规疗法治疗,观察组在对照组基础上加用"郭氏六联疗法"治疗.2组均治疗7 d.采用ELISA法检测血浆TNF-α、IL-1、IL-6、IL-8、IL-10及肠三叶因子(intestinal trefoil factor,ITF)、乳脂球表皮生长因子8(cream cell epidermal growth factor 8,MFG-E8)水平;采用紫外分光光度法测定血浆二胺氧化酶(diamine oxidase,DAO)、D-乳酸、内毒素(endotoxin,ET)和脂多糖(lipopolysaccharide,LPS)水平;采用HPLC法检测尿乳果糖/甘露醇(L/M)值;观察并记录患者肠麻痹缓解时间.结果治疗后,观察组腹痛及腹胀缓解时间、肠鸣音恢复时间、肛门首次排便时间均早于对照组(t值分别为7.621、5.332、6.625、8.762,P值均<0.01).治疗后,观察组血浆LPS、DAO、ET、D-乳酸水平均低于对照组(t值分别为9.856、6.974、9.784、16.068,P值均<0.01);血浆ITF、MFG-E8水平均高于对照组(t值分别为20.118、23.031,P值均<0.01),尿L/M值均低于对照组(t=23.469,P<0.01);血浆TNF-α、IL-1、IL-6、IL-8、IL-10水平均低于对照组(t值分别为9.550、12.506、22.343、16.625、6.774,P值均<0.01).结论"郭氏六联疗法"可明显降低AP肠黏膜屏障功能障碍患者的肠麻痹缓解时间,减轻炎症反应,提高血浆ITF、MFG-E8水平,修复肠黏膜通透性,改善肠道屏障功能.Objective To investigate the clinical research of Guo's Liulian therapy in treating acute pancreatitis intestinal mucosal barrier dysfunction and provide reference for the patients with acute pancreatitis. Methods The 68 patients with acute pancreatitis who were admitted to our hospital from September 2016 to May 2018 were selected as study subjects. According to the random number table method, the patients were divided into the observation group and the control group, with 34 cases in each group. The patients in the control group were treated with conventional western medicine. The patients in the observation group were treated with Guo's Liulian therapy on the basis of the above treatment. The time of intestinal paralysis was compared between the two groups. The changes of intestinal mucosal barrier function and serum inflammatory factor related indexes before and after treatment were analyzed in the two groups. The difference of therapeutic effects between the two groups was observed. Results In the observation group, the abdominal pain relief time, abdominal distention relief time, bowel sound recovery time, and first bowel anus defecation time were significantly lower than those in the control group (t=7.621, 5.332 6.625, 8.762, all Ps<0.01). After treatment, serum LPS, DAO, ET, D-lactic acid, TNF-α, IL-1, IL-6, IL-8, and IL-10 and urine L/M were significantly lower in the observation group, while the serum ITF and MFG-E8 were significantly higher in the observation group (t=9.856, 6.974, 9.784, 16.068, 9.550, 12.506, 22.343, 16.625, 6.774, 23.469, 20.118, 23.031, all Ps<0.01). Conclusions The Guo's Liulian therapy treatment of acute pancreatitis in patients with intestinal mucosal barrier dysfunction can reduce the palsy remission time, reduce inflammation, increase serum ITF, MFG-E8 levels, repair of intestinal permeability, and improve the intestinal barrier function.

关 键 词：胰腺炎 急性坏死性 郭氏六联疗法 肠黏膜屏障 炎性细胞因子 

分 类 号：R57[医药卫生—消化系统]