通腑消毒饮灌肠、外敷联合埃索美拉唑对重症急性胰腺炎患者肠黏膜屏障功能、炎症状态的影响  

Effect of Tongfuxiaoduyin enema and external application combined with esomeprazole on intestinal mucosal barrier function and inflammatory state in patients with severe acute pancreatitis

作　　者：韦忠丽 宋洪伟 Wei Zhongli(Taian Chinese Medicine Hospital,Taian 271000,China)

机构地区：[1]泰安市中医医院,山东泰安271000 [2]不详

出　　处：《山东第一医科大学（山东省医学科学院）学报》2021年第8期602-605,共4页Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences

摘　　要：目的探究通腑消毒饮灌肠、外敷联合埃索美拉唑治疗重症急性胰腺炎的效果,探讨其对患者肠黏膜屏障功能、炎症状态的影响。方法将90例重症急性胰腺炎患者随机分为对照组和观察组患者各45例。对照组给予埃索美拉唑治疗,观察组在对照组基础上加用通腑消毒饮灌肠、外敷治疗,连续治疗7 d。比较两组的病情严重程度、肠黏膜屏障功能指标、炎症状态相关指标变化。结果与对照组相比,观察组治疗后的APACHE评分、Balthazar CT分级评分均显著降低,差异有统计学意义(P<0.05)。与对照组相比,观察组治疗后肠黏膜屏障功能指标D-乳酸、血清淀粉酶(AMS)、二胺氧化酶(DAO)均下降更明显,差异有统计学意义(P<0.05)。与对照组相比,观察组治疗后血清中炎症状态相关指标sICAM-1、MCP-1均下降更明显,MFG-E8含量则上升更明显,差异有统计学意义(P<0.05)。结论通腑消毒饮灌肠、外敷联合埃索美拉唑更利于减轻重症急性胰腺炎患者的病情,促进肠黏膜屏障功能的恢复,改善预后,其起效可能与通过抑制sICAM-1、MCP-1表达、促进MFG-E8分泌以减轻炎症反应、保护肠道屏障有关,值得临床推广应用。Objective:To explore the effect of Tongfuxiaoduyin enema and external application combined with esomeprazole in the treatment of severe acute pancreatitis,and to explore the effect of it on intestinal mucosal barrier function and inflammatory state of patients.Methods:Ninety patients with severe acute pancreatitis were randomly divided into control group and observation group,with 45 patients in each group.The control group was treated with esomeprazole,and the observation group was additionally treated with Tongfuxiaoduyin enema and external application on the basis of the treatment in the control group.The treatment lasted for 7 days.The severity of the disease,intestinal mucosal barrier function and inflammatory status were compared between the two groups.Results:Compared with the control group,the Apache score and Balthazar CT score in the observation group were significantly decreased after treatment,with statistical significance(P<0.05).Compared with the control group,the indexes of intestinal mucosal barrier function(D-lactic acid,AMS,DAO)decreased more significantly in the observation group after treatment,with statistical significance(P<0.05).Compared with the control group,the serum inflammatory state related indexes of SICAM-1 and MCP-1 in the observation group decreased more obviously after treatment,while the content of MFG-E8 increased more obviously,the difference was statistically significant(P<0.05).Conclusion:Tongfuxiaoduyin enema and external application combined with esomeprazole is more conducive to reduce the severity of patients with acute pancreatitis,promote the recovery of intestinal mucosal barrier function and improve the prognosis,whose effect may be related to the inhibition of SICAM-1,MCP-1 expression,promotion of the secretion of MFG-E8 to reduce inflammatory response and protection of the intestinal barrier,which is worthy of clinical application.

关 键 词：重症急性胰腺炎 灌肠 外敷 埃索美拉唑 肠粘膜屏障功能 炎症状态 中西医结合 

分 类 号：R576[医药卫生—消化系统]