通腑安涤汤灌肠辅助治疗对重症急性胰腺炎血清炎症因子的影响  

Effect of Enema with Tongfu Andi Decoction on Serum Inflammatory Factors in Patients with Severe Acute Pancreatitis

作　　者：韩雪 陈治国[1] 宋云骏 HAN Xue;CHEN Zhiguo;SONG Yunjun(Emergency Department of Chengde Central Hospital,Chengde 067000,Hebei,China)

机构地区：[1]承德市中心医院急诊科,河北承德067000

出　　处：《中华中医药学刊》2020年第11期233-236,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：河北省自然科学基金(H2018206115)。

摘　　要：目的观察通腑安涤汤灌肠辅助治疗对重症急性胰腺炎患者血清炎症因子的影响。方法选择2016年4月—2019年8月医院收治的重症急性胰腺炎患者110例,依据随机对照法将患者分为治疗组和对照组,每组55例。对照组采用常规医学手段进行治疗,治疗组在对照组治疗的基础上,采用通腑安涤汤灌肠辅助治疗。两组均治疗14 d。比较两组治疗疗效,比较两组治疗前后中医证候积分,比较两组临床症状和体征消失时间,比较血清炎症因子和血清淀粉酶水平,比较两组治疗前后Ranson评分、SIRS评分和改良Marshall评分。结果治疗组中医总有效率为90.91%(50/55)高于对照组中医总有效率为76.36%(42/55)(P<0.05);治疗组治疗后中医症候腹满硬痛拒按、大便燥结、胸脘痞闷不舒、恶心呕吐和小便短赤等积分低于对照组(P<0.05);治疗组患者腹胀缓解时间、腹痛缓解时间、肠鸣音缓解时间、肛门排便时间和体温恢复时间均低于对照组(P<0.05);治疗组治疗后血清炎症因子IL-6、CRP、PCT水平和血清淀粉酶水平低于对照组(P<0.05);治疗组治疗后Ranson评分、SIRS评分和改良Marshall评分低于对照组(P<0.05)。结论通腑安涤汤灌肠辅助治疗重症急性胰腺炎取得了较为满意的临床效果,能降低患者的中医证候积分,快速促进临床症状消退,有效的抑制患者的炎症反应,改善预后,值得进一步研究探讨。Objective To observe the effect of Tongfu Andi Decoction for enema on serum inflammatory factors in patients with severe acute pancreatitis. Methods A total of 110 cases of severe acute pancreatitis admitted to our hospital from April 2016 to August 2019 were selected, and the patients were divided into treatment group and control group according to the randomized control method, with 55 cases in each group. The control group was treated with conventional medical means, and the treatment group was treated with Tongfu Andi Decoction for enema as auxiliary treatment on the basis of the treatment of the control group. Both groups were treated for 14 days. The therapeutic effects of the two groups were compared. The TCM symptom scores before and after treatment were compared. The disappearance time of clinical symptoms and signs were compared. The serum inflammatory factors and serum amylase levels were compared, and the Ranson score, SIRS score and modified Marshall score before and after treatment were compared. Results The total effective rate of TCM in the treatment group was 90.91%(50/55),higher than that in the control group(76.36%,42/55)(P<0.05). After treatment, the TCM symptoms scores of abdominal fullness and pain, dry stool, chest tightness and discomfort, nausea and vomiting and urinal shortness were lower in the treatment group than those in the control group(P<0.05). The relief time of abdominal distension, abdominal pain, bowel sounds, anal defecation and body temperature in the treatment group were all shorter than those in the control group(P<0.05). The levels of serum inflammatory cytokines IL-6, CRP, PCT and serum amylase in the treatment group were lower than those in the control group(P<0.05). The Ranson, SIRS and modified Marshall scores in the treatment group were lower than those in the control group(P<0.05). Conclusion Tongfu Andi Decoction has achieved satisfactory clinical effect in the auxiliary treatment of severe acute pancreatitis, which can reduce the TCM syndrome score of patients, ra

关 键 词：通腑安涤汤 重症急性胰腺炎 血清淀粉酶 影响 

分 类 号：R259.76[医药卫生—中西医结合]