柴芩承气汤联合生长抑素辅助治疗轻中度急性胰腺炎的效果及对炎性因子、免疫因子的影响  

Clinical Effect of Chaiqin Chengqi Decoction Combined with Somatostatin in the Adjuvant Treatment of Mild to Moderate Acute Pancreatitis and Its Influence on Inflammatory Factors and Immune Factors

作　　者：付新新[1] 姚红梅[2] 路璐[3] 张金卓[2] 张新文[4] 张晓明[1] FU Xin-xin;YAO Hong-mei;LU Lu;ZHANG Jin-zhuo;ZHANG Xin-wen;ZHANG Xiao-ming(a.Department of Gastroenterology Two,the First Central Hospital of Baoding,Baoding,Hebei 071000,China;Department of Gastroenterology Three,the First Central Hospital of Baoding,Baoding,Hebei 071000,China;Department of Endoscopy Center,the First Central Hospital of Baoding,Baoding,Hebei 071000,China;Department of Integrated Chinese and Western Medicine,Affiliated Hospital of Hebei University,Baoding,Hebei 071000,China)

机构地区：[1]保定市第一中心医院消化二科,河北保定071000 [2]保定市第一中心医院消化三科,河北保定071000 [3]保定市第一中心医院内镜中心,河北保定071000 [4]河北大学附属医院中西医结合科,河北保定071000

出　　处：《临床误诊误治》2021年第2期24-29,共6页Clinical Misdiagnosis & Mistherapy

基　　金：保定市科技计划项目(18ZF100)。

摘　　要：目的探讨柴芩承气汤联合生长抑素辅助治疗轻中度急性胰腺炎的效果及对炎性因子、免疫因子的影响。方法选取2019年2月—2020年7月我院收治的轻中度急性胰腺炎79例,根据治疗方法的不同分为观察组42例和对照组37例,对照组在常规治疗基础上加用生长抑素治疗,观察组在对照组基础上加用柴芩承气汤治疗。治疗7 d后比较两组疗效、症状体征缓解时间,治疗前后血尿淀粉酶、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]及CD4+、CD8+、CD4+/CD8+水平,以及治疗期间不良反应发生情况。结果治疗7 d后,观察组总有效率为90.48%高于对照组的72.97%(χ^2=4.133,P=0.042);观察组腹胀缓解时间、腹痛缓解时间、肠鸣音恢复时间、热退时间均短于对照组(P<0.01);治疗后两组血尿淀粉酶、TNF-α、IL-6、CRP均较治疗前降低,且观察组降低程度大于对照组,差异有统计学意义(P<0.01);治疗后两组CD4+、CD4+/CD8+较治疗前升高,CD8+较治疗前降低,且观察组CD4+、CD4+/CD8+升高及CD8+降低程度均大于对照组,差异有统计学意义(P<0.01)。两组治疗期间均未见明显不良反应发生。结论柴芩承气汤联合生长抑素辅助治疗轻中度急性胰腺炎可有效提高疗效,缩短症状体征缓解时间,并可极大改善机体血尿淀粉酶水平,抑制胰腺分泌和消化,减少机体炎性因子产生,减轻炎性反应程度,改善机体免疫功能,且安全性较好。Objective To investigate the effect of Chaiqin Chengqi Decoction Combined with somatostatin in the adjuvant treatment of mild to moderate acute pancreatitis and its influence on inflammatory factors and immune factors.Methods 79 cases of mild to moderate acute pancreatitis in our hospital from February 2019 to July 2020 were selected and divided into observation group(42 cases)and control group(37 cases)according to different treatment methods.The control group was treated with somatostatin on the basis of conventional treatment,and the observation group was treated with Chaiqin Chengqi Decoction on the basis of the control group.After 7 days of treatment,the curative effect,remission time of symptoms and signs,blood and urine amylase,inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]and levels of CD4+,CD8+,CD4+/CD8+were compared between the two groups before and after treatment,as well as the incidence of adverse reactions during the treatment.Results Treatment 7 d later,the total effective rate of the observation group was 90.48%,which was higher than 72.97%of the control group(χ^2=4.133,P=0.042);the abdominal distension relief time,abdominal pain relief time,bowel sound recovery time,and heat regression time in the observation group were shorter than those in the control group(P<0.01);after treatment,the levels of serum and urine amylase,TNF-α,IL-6,CRP in the two groups were lower than those before treatment,and the degree of reduction in the observation group was greater than that in the control group,the difference was statistically significant(P<0.01);after treatment,the levels of CD4+,CD4+/CD8+and CD8+in the two groups were higher than those before treatment,and the levels of CD4+,CD4+/CD8+and CD8+in the observation group were higher than those in the control group(P<0.01).No obvious adverse reactions occurred during the treatment in both groups.Conclusion Chaiqin Chengqi Decoction Combined with somatostatin in the treatment of mild to moderate acute pancre

关 键 词：胰腺炎 柴芩承气汤 生长抑素 淀粉酶 肿瘤坏死因子α 白细胞介素6 CD4+ CD8+ 药物毒性 

分 类 号：R576[医药卫生—消化系统]