抑胰合剂联合早期肠内营养对重症急性胰腺炎肠黏膜屏障及并发症的影响  

Effects of Yiyi Mixture and early enteral nutrition on intestinal mucosal barrier and complications of severe acute pancreatitis

作　　者：王倩倩 周健[1] 江志伟 龚冠闻 WANG Qian-qian;ZHOU Jian;JIANG Zhi-wei;GONG Guan-wen(Nantong Hospital Affiliated to Nanjing University of Chinese Medicine,Nantong 226000,China;Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210000,China)

机构地区：[1]南京中医药大学南通附属医院,南通226000 [2]南京中医药大学附属医院,南京210000

出　　处：《中华中医药杂志》2023年第3期1370-1374,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81704083);江苏省中医药管理局专题研究项目(No.ZT202108);南京市科技委面上项目(No.201715005)。

摘　　要：目的:探讨抑胰合剂对重症急性胰腺炎(SAP)肠黏膜屏障及并发症的影响。方法:纳入自2016年1月至2020年12月南京中医药大学附属医院收治的SAP患者80例,随机分为治疗组和对照组,每组40例,对照组给予西医常规治疗和早期肠内营养,治疗组在对照组基础上给予抑胰合剂鼻饲,比较两组患者的胃肠功能(腹痛、腹胀、肠鸣音、排气)恢复时间、住院时间、肠黏膜屏障指标(内毒素、二胺氧化酶、D-乳酸)、肠道菌群结构(乳酸杆菌、双歧杆菌、大肠杆菌、肠球菌)、并发症(感染性胰腺坏死、全身炎症反应综合征、多器官功能障碍综合征、脓毒血症、腹腔间隔室综合征)发生率的差异。结果:治疗组的胃肠功能恢复时间、住院时间均显著少于对照组;两组肠黏膜屏障指标均较治疗前显著降低,且治疗组显著低于对照组;两组乳酸杆菌、双歧杆菌均较治疗前显著增加,大肠杆菌、肠球菌均较治疗前显著减少,且治疗组改善优于对照组;治疗组各项并发症发生率均显著低于对照组;以上各项差异均有统计学意义(P<0.05)。结论:抑胰合剂联合早期肠内营养可以缩短SAP患者胃肠功能恢复时间、住院时间,增强肠黏膜屏障,调节肠道菌群结构,减少并发症,改善预后。Objective:To explore the effect of Yiyi Mixture on intestinal mucosal barrier and complications of severe acute pancreatitis(SAP).Methods:A total of 80 SAP patients admitted to the hospital from January 2016 to December 2020 were enrolled and randomly divided into treatment group and control group,40 cases in each group.The control group was given conventional western medicine treatment and early enteral nutrition,while the treatment group was given nasal feeding with Yiyi Mixture on the basis of the control group.The differences in the recovery time of gastrointestinal functions,length of hospitalization,intestinal mucosal barrier indexes,intestinal flora structure,and incidence of complications of the two groups were compared.Results:The recovery time of gastrointestinal functions(abdominal pain,abdominal distension,bowel sounds,and exhaust)in the treatment group was shorter than the control group.The length of hospitalization was shorter in the treatment group than that in the control group.The intestinal mucosal barrier indexes(endotoxin,diamine oxidase,D-lactic acid)of the two groups were lower than before treatment,and those of the treatment group were lower than the control group.Both lactobacillus and bifidobacteria of the two groups were higher than before treatment;escherichia coli and enterococcus of the two groups were lower than before treatment,and the improvement of the treatment group was better than the control group.The incidence of complications include infected pancreatic necrosis,systemic inflammatory response syndrome,multiple organ dysfunction syndrome,sepsis and abdominal compartment syndrome in the treatment group was lower than the control group,the above differences were statistically significant(P<0.05).Conclusion:Yiyi Mixture combined with early enteral nutrition can shorten the recovery time of gastrointestinal functions in SAP patients,reduce the length of hospitalization,strengthen the intestinal mucosal barrier,adjust the structure of intestinal flora,reduce complications,and impr

关 键 词：重症急性胰腺炎 肠黏膜屏障 并发症 肠内营养 抑胰合剂 临床研究 

分 类 号：R576[医药卫生—消化系统]