清胰通腑汤联合生长抑素对重症急性胰腺炎并发麻痹性肠梗阻患者Th17/Treg细胞平衡及相关因子的影响  

Effect of Qingyi Tongfu Decoction Combined with Somatostatin on Th17/Treg Cell Balance and Related Factors in Patients with Severe Acute Pancreatitis Complicated with Paralytic Intestinal Obstruction

作　　者：蔡照弟[1] 奚耀[1] 王重卿[1] Cai Zhaodi;Xi Yao;Wang Zhongqing(Yueyang Hospital of Integrated Chinese and Western medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院

出　　处：《中国中医急症》2019年第12期2142-2145,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：上海市进一步加快中医药事业发展三年行动计划建设项目(ZY3-JSFC-2-1049)

摘　　要：目的观察清胰通腑汤联合生长抑素对重症急性胰腺炎并发麻痹性肠梗阻患者Th17(辅助性T细胞17)/Treg(调节性T细胞)细胞平衡及相关因子的影响。方法患者52例按随机数字表法分成对照组与研究组各26例。对照组采用生长抑素治疗,研究组在对照组的治疗基础上联合清胰通腑汤治疗。观察并比较两组患者临床疗效、首次排气时间、首次排便时间、开放饮食时间、住院时间、白细胞介素-6(IL-6)、转化生长因子-β(TGF-β)水平、Th17/Treg细胞失衡细胞比值与IL-6水平的相关性、不良反应的具体情况。结果研究组患者总有效率(96.15%)高于对照组(76.92%)(P <0.05);研究组患者首次排气时间、首次排便时间、开放饮食时间、住院时间均低于对照组,差异具有统计学意义(P <0.05);治疗后,两组患者IL-6水平均较前降低,TGF-β水平均较前升高,研究组降低、升高程度均大于对照组(P <0.05);对研究组Th17/Treg细胞失衡细胞比值与IL-6水平的相关性分析,显示两者之间Spearman相关系数为0.780(P <0.05),呈显著相关;研究组不良反应总发生率(3.85%)低于对照组(26.92%)(P <0.05)。结论清胰通腑汤联合生长抑素对重症急性胰腺炎并发麻痹性肠梗阻患者具有良好的临床疗效,可增强患者Treg细胞分化和功能,抑制Th17细胞的分化,继而恢复患者机体Th17/Treg细胞平衡,且安全性高。Objective:To investigate effect of Qingyi Tongfu Decoction combined with somatostatin on helper T cell 17/regulatory T cell(Th17/Treg)balance and related factors in patients with severe acute pancreatitis complicated with paralytic intestinal obstruction,and to provide effective theoretical basis for better treatment. Methods:52 patients were divided into two groups according to the random number table,26 cases in each group. The control group was treated with somatostatin,and the study group was treated with Qingyi Tongfu Decoction on the basis of the control group. Then the clinical efficacy,first exhaust time,first defecation time,open diet time,hospitalization time,IL-6,TGF-β level,correlation between the imbalance ratio of Th17/Treg cell and IL-6 level as well as the adverse reactions were recorded and compared between groups. Results:The total effective rate of the study group(96.15%)was higher than that of the control group(76.92%)(P < 0.05);The first exhaust time,first defecation time,open diet time,and hospital stay were lower in the study group than in the control group(P <0.05). After treatment,the IL-6 levels were decreased in the two groups and the TGF-β levels were increased,and both changes were more obvious in the study group than in the control group(P < 0.05). Correlation analysis showed that the Spearman correlation coefficient of Th17/Treg cell imbalance cell ratio and IL-6 level in the study group was 0.780(P < 0.05),which was significantly correlated. The total incidence of adverse reactions in the study group was lower than that in the control group(P < 0.05). Conclusion:The application of Qingyi Tongfu Decoction combined with somatostatin can effectively and safely ameliorate the Th17/Treg cell balance by promoting the differentiation of Treg cells and inhibiting the differentiation of Th17 cells,which is worthy of promotion.

关 键 词：重症急性胰腺炎 麻痹性肠梗阻 清胰通腑汤 生长抑素 Th17/Treg细胞平衡 临床价值 

分 类 号：R576[医药卫生—消化系统]