清胰通腑汤治疗高血脂症性胰腺炎疗效观察  

Observation on therapeutic effect of Qingyi Tongfu Decoction on hyperlipidemia pancreatitis

作　　者：严晓红 周雯 张晓静 曹鹏飞 筵玉格 王鼎鑫[2] YAN Xiaohong;ZHOU Wen;ZHANG Xiaojing;CAO Pengfei;YAN Yuge;WANG Dingxin(Hebei Yiling Hospital, Shijiazhuang 050091, Hebei,China;Hebei General Hospital,Shijiazhuang 050061,Hebei,China)

机构地区：[1]河北以岭医院,河北石家庄050091 [2]河北省人民医院,河北石家庄050061

出　　处：《现代中西医结合杂志》2020年第31期3446-3450,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2019196)。

摘　　要：目的观察清胰通腑汤治疗高血脂症性胰腺炎的疗效。方法采用随机分组法将2016年12月—2019年1月河北以岭医院收治的60例高血脂症性胰腺炎患者分为治疗组和对照组各30例,2组均给予相同西医治疗,治疗组同时通过鼻胃管和灌肠方式给予清胰通腑汤治疗。检测2组治疗前、治疗第3天、治疗第7天血脂指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平、白细胞计数(WBC)、C反应蛋白(CRP)水平,比较2组治疗前及治疗7 d后EPIC评分和BISAP评分,记录2组治疗第3天、治疗第7天血淀粉酶正常率和治疗7 d后CT缓解率,统计2组随访12个月内胰腺炎复发率。结果治疗第3天和治疗第7天,2组TC、TG、LDL-C、CRP水平及WBC均明显低于治疗前(P均<0.05),治疗组TG、LDL-C、CRP水平均明显低于对照组(P均<0.05),但2组间TC比较差异无统计学意义(P>0.05);2组血清HDL-C水平均明显高于治疗前(P均<0.05),且治疗第3天治疗组血清HDL-C水平明显高于对照组(P<0.05)。治疗后2组EPIC评分、BISAP评分均明显低于治疗前(P均<0.05),治疗后2组间EPIC评分、BISAP评分比较差异均无统计学意义(P均>0.05)。治疗第3天和治疗第7天,治疗组血清淀粉酶恢复正常率分别为60.0%(18/30)和96.7%(29/30),对照组分别为33.3%(10/30)和66.7%(20/30),治疗组均明显高于对照组(P均<0.05)。治疗7 d后,治疗组显效率和总有效率均明显高于对照组(P均<0.05)。随访12个月内,治疗组复发率明显低于对照组(P<0.05)。结论在络病理论指导下应用清胰通腑汤治疗高血脂症性胰腺炎可以迅速降低患者血清TG、LDL-C水平,减轻炎症反应,促进病情恢复,并且可以降低短期复发率。Objective It is to observe the curative effect of Qingyi Tongfu Decoction on hyperlipidemia pancreatitis.Methods 60 patients with hyperlipidemia pancreatitis who were admitted to Hebei Yiling Hospital from December 2016 to January 2019 were randomly divided into a treatment group and a control group with 30 cases in each group.The two groups were treated with the same western medicine,the treatment group was treated with Qingyi Tongfu Decoction by nasogastric tube and enema at the same time.The levels of blood lipid indexes[total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)],white blood cell count(WBC),and the level of C-reactive protein(CRP)were determined before treatment,on the 3rd and 7th day of treatment in the two groups,the EPIC score and BISAP score of the two groups before treatment and 7 days after treatment were compared between the two groups,the normal rate of blood amylase on the 3rd day of treatment and the 7th day of treatment and the CT remission rate after 7 days of treatment were recorded in the 2 groups,the recurrence rate of pancreatitis in the 2 groups within 12 months of follow-up were calculated.Results On the 3rd and 7th day of treatment,the levels of TC,TG,LDL-C,CRP and WBC were significantly lower than those before treatment in the 2 groups(all P<0.05),and the levels of TG,LDL-C and CRP in the treatment group were significantly lower than those in the control group(P<0.05),but the difference in TC between the two groups was not statistically significant(P>0.05);the levels of serum HDL-C in the two groups were significantly higher than that before treatment(P<0.05),and on the third day of treatment,the serum HDL-C level of the treatment group was significantly higher than that of the control group(P<0.05).After treatment,the EPIC score and BISAP score of the two groups were significantly lower than those before treatment(P<0.05),and there was no significant difference in EPIC score and BISAP score between the t

关 键 词：高血脂症性胰腺炎 络病理论 清胰通腑汤 三酰甘油 

分 类 号：R576[医药卫生—消化系统]