活血清胰汤灌肠辅助手术治疗对急性重症胰腺炎患者的疗效观察  

Clinical Observation on the Effects of Huoxue Qingyi Decoction Adjuvant Surgical Treatment on Patients with Acute Severe Pancreatitis

作　　者：李博伟[1] 李亚斌[1] 齐亚刚 王塬[1] 王博林[1] 牛钢[1] LI Bowei;LI Yabin;QI Yagang;WANG Yuan;WANG Bolin;NIU Gang(The Second Department of Surgery,Baoji City Hospital of Traditional Chinese Medicine of Shannxi Province,Baoji 721000,China)

机构地区：[1]陕西省宝鸡市中医医院外二科,宝鸡721000

出　　处：《世界中医药》2020年第20期3101-3104,共4页World Chinese Medicine

基　　金：陕西省中医药科技发展计划项目(2017-1243)。

摘　　要：目的:探讨活血清胰汤灌肠辅助手术治疗急性重症胰腺炎对患者AMS、UAMY、LPS水平及免疫功能的影响。方法:选取2019年3月至2020年3月陕西省宝鸡市中医医院收治的急性重症胰腺炎患者70例作为研究对象,按随机数字表法将其分为对照组和观察组,每组35例。2组均采用经内镜逆行性胰胆管造影术进行治疗,对照组术后给予常规治疗,观察组术后在对照组的基础上加用活血清胰汤灌肠治疗,2组均治疗1周。比较2组治疗1周后的临床疗效;比较2组治疗前、治疗1周后的胰腺炎标志物水平、细胞免疫指标及体液免疫指标水平。结果:治疗1周后,观察组总有效率为94.29%,高于对照组(77.14%,P<0.05)。与治疗前比较,治疗1周后,2组血清AMS、LPS、UAMY及CD8+水平均降低,且观察组低于对照组(P<0.05);2组血清CD3+、CD4+、IgG、IgM、IgA水平及CD4+/CD8+比值均升高,且观察组高于对照组(P<0.05)。结论:活血清胰汤灌肠辅助手术治疗急性重症胰腺炎,可通过降低患者血清AMS、LPS及UAMY水平,缓解炎性反应,同时可改善免疫功能,进而有助于提高疗效。Objective:To investigate the effects of Huoxue Qingyi Decoction adjuvant surgical treatment on AMS,UAMY,LPS level and immune function in patients with acute severe pancreatitis.Methods:A total of 70 patients with acute severe pancreatitis admitted to Baoji City Hospital of Traditional Chinese Medicine of Shannxi Province from March 2019 to March 2020 were selected as the research objects and were divided into a control group(n=35)and an observation group(n=35).Both groups were treated with endoscopic retrograde cholangiopancreatography.The control group was given conventional treatment after surgery,and the observation group was treated with Huoxue Qingyi Decoction on the basis of the control group after surgery.Both groups were treated for 1 week.The clinical efficacy of the 2 groups after 1 week of treatment was compared;the levels of pancreatitis markers,cellular immune indicators and humoral immune indicators before and after 1 week of treatment between the 2 groups were compared.Results:After 1 week of treatment,the total effective rate in the observation group was 94.29%,higher than the control group(77.14%,P<0.05).Compared with before treatment,after 1 week of treatment,the levels of serum AMS,LPS,UAMY and CD8+in the 2 groups decreased,and the observation group were lower than the control group(P<0.05);the levels of serum CD3+,CD4+,IgG,IgM,IgA and ratio of CD4+/CD8+in the 2 groups increased,and the observation group were higher than the control group(P<0.05).Conclusion:Huoxue Qingyi Decoction adjuvant surgical treatment can reduce the level of serum AMS,LPS and UAMY of the patients,relieve inflammation,and improve immune function,thereby helping to improve the efficacy.

关 键 词：急性胰腺炎 重症 活血清胰汤 经内镜逆行性胰胆管造影术 淀粉酶 尿淀粉酶 脂多糖 免疫功能 

分 类 号：R256.22[医药卫生—中医内科学] R322.4+91[医药卫生—中医学]