连续血液滤过联合大黄通便颗粒治疗重症胰腺炎的效果及其对肠黏膜屏障功能的影响  

Efficacy of continuous hemofiltration combined with Rhubarb Laxative Granule for the treatment of severe pancreatitis and its effect on intestinal barrier function

作　　者：郭利洁 黄武军[2] 符兆胤[2] 张河[1] 黄乙江[1] 黄志卫[2] GUO Li-jie;HUANG Wu-jun;FU Zhao-yin;ZHANG He;HUANG Yi-jiang;HUANG Zhi-wei(Department of Nephrology,2 Intensive Care Unit,the First People′s Hospital of Qinzhou,Qinzhou 535000,China)

机构地区：[1]广西钦州市第一人民医院肾内科,钦州市535000 [2]广西钦州市第一人民医院重症医学科,钦州市535000

出　　处：《广西医学》2020年第3期277-281,共5页Guangxi Medical Journal

基　　金：广西钦州市科学研究与技术开发计划(201616814)。

摘　　要：目的探讨连续血液滤过联合大黄通便颗粒治疗重症胰腺炎(SAP)的效果及其对肠黏膜屏障功能的影响。方法将124例SAP患者随机分为观察组和对照组,各62例。在常规基础治疗的基础上,对照组采用连续血液滤过治疗,观察组采用连续血液滤过联合大黄通便颗粒治疗。比较两组的临床疗效、临床指标、血淀粉酶、尿淀粉酶、炎症因子,以及肠道黏膜屏障功能指标、病情严重程度的各项量表评分和不良反应发生情况。结果观察组的治疗总有效率高于对照组(P<0.05)。观察组的腹痛缓解时间、首次排便时间和住院时间均短于对照组,血淀粉酶、尿淀粉酶、肿瘤坏死因子α、白细胞介素6、内毒素、D-乳酸和二胺氧化酶水平,以及Ranson评分、急性生理学与慢性健康状况Ⅱ评分、不良反应发生率均低于对照组(均P<0.05)。结论连续血液滤过联合大黄通便颗粒治疗SAP疗效显著,能有效地抑制炎症,促进肠道黏膜屏障功能恢复,并减少不良反应。Objective To investigate the efficacy of continuous hemofiltration combined with Rhubarb Laxative Granule foRthe treatment of severe pancreatitis(SAP)and its effect on intestinal barrieRfunction.Methods A total of 124 patients with SAP were randomly divided into observation group and control group,with 62 cases in each groups.Based on conventional basic treatment,the control group was treated with continuous hemofiltration,and the observation group was treated with continuous hemofiltration combined with Rhubarb Laxative Granule.Clinical efficacy,clinical indicators,serum and urine amylase,inflammatory factors,intestinal barrieRfunction indexes,scores foReach item of the scale assessing disease severity,and incidence of adverse reactions were compared between the two groups.Results The total effective rate foRtreatment of the observation group was higheRthan that of the control group(P<0.05).The observation group obtained shorteRabdominal pain relief time,first defecation time and hospitalization time,loweRlevels of serum amylase,urine amylase,tumoRnecrosis factoRα,interleukin 6,endotoxin,D-lactate and diamine oxidase,as well as loweRRanson score,Acute Physiology and Chronic Health EvaluationⅡscore and incidence rate of adverse reactions,as compared with the control group(all P<0.05).Conclusions Continuous hemofiltration combined with Rhubarb Laxative Granule has a notable efficacy foRtreating SAP,which can effectively inhibit inflammation,promote the recovery of intestinal barrieRfunction,and reduce adverse reactions.

关 键 词：连续血液滤过 大黄通便颗粒 重症胰腺炎 肠黏膜屏障功能 炎症因子 疗效 

分 类 号：R459.5[医药卫生—治疗学] R576[医药卫生—临床医学]