柴胡疏肝散联合足三里针刺对急性胰腺炎患者血清炎症及免疫指标的影响  

Effect of Chaihu Shugan Powder plus needling Zusanli(ST 36)on serum inflammatory factors and immune indexes in patients with acute pancreatitis

作　　者：路薇薇 钱小强[3] 杨敏[4] 王晓素 倪建俐[5,6] LU Weiwei;QIAN Xiaoqiang;YANG Min;WANG Xiaosu;NI Jianli(Department of Gastroenterology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Department of General Practice,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China;Reproductive Medicine Center,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China;Liangcheng Xincun Street Community Health Service Center of Hongkou District,Shanghai 200080,China;Department of Traditional Chinese Medicine,Chongming Hospital,Shanghai University of Medicine&Health Sciences,Shanghai 202150,China;Department of Traditional Chinese Medicine,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院消化科,上海200437 [2]上海交通大学医学院附属新华医院全科医学科,上海200092 [3]上海交通大学医学院附属新华医院生殖医学中心,上海200092 [4]上海市虹口区凉城新村街道社区卫生服务中心,上海200080 [5]上海健康医学院附属崇明医院中医科,上海202150 [6]上海交通大学医学院附属新华医院中医科,上海200092

出　　处：《上海中医药杂志》2023年第6期80-83,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市卫健委上海市综合医院中西医结合专项(ZHYY-ZXYJHZX-201914)。

摘　　要：目的观察柴胡疏肝散联合足三里针刺对急性胰腺炎患者血清炎症及免疫指标的影响。方法将80例急性胰腺炎肝郁气滞证患者随机分为治疗组、对照组,每组40例。对照组给予内科综合治疗,治疗组在此基础上加用柴胡疏肝散口服以及足三里针刺,中医特色疗法疗程为5 d。观察治疗前、治疗后(即治疗5 d后,下同)两组患者血淀粉酶、脂肪酶、炎症指标[肿瘤坏死因子-α(TNF-α),白细胞(WBC)计数、中性粒细胞百分比(NE%)、C反应蛋白(CRP)、白介素-6(IL-6)、白介素-8(IL-8)、白介素-1β(IL-1β)]、免疫指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平的变化情况。结果①治疗前后组内比较,两组血清淀粉酶、脂肪酶水平降低(P<0.05);组间治疗后比较,治疗组血清淀粉酶、脂肪酶水平低于对照组(P<0.05)。②治疗前后组内比较,两组血清TNF-α、WBC计数、NE%、CRP、IL-6、IL-8、IL-1β水平降低(P<0.05);组间治疗后比较,治疗组血清TNF-α、CRP、IL-8、IL-1β水平低于对照组(P<0.05)。③治疗前后组内比较,两组血清CD3^(+)、CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+)值升高(P<0.05);组间治疗后比较,治疗组血清CD3^(+)、CD4^(+)水平高于对照组(P<0.05)。④试验期间,两组患者均未见明显不良反应,安全性良好。结论与单纯采用内科综合治疗相比,加用柴胡疏肝散口服以及足三里针刺治疗急性胰腺炎能更好地减轻机体炎症反应、调节免疫状态,从而促进疾病康复。Objective To observe the effect of Chaihu Shugan Powder plus needling Zusanli(ST 36)on serum inflammatory factors and immune indexes in patients with acute pancreatitis.Methods Eighty patients with acute pancreatitis of liver depression and qi stagnation syndrome were randomly divided into the treatment group(n=40)and the control group(n=40).Patients in the control group were given comprehensive internal medicine treatment while patients in the treatment group were treated with Chaihu Shugan Powder plus needling Zusanli(ST36)for five days in addition to the conventional medical treatment.We observed the changes in the levels of serum amylase,serum lipase,inflammatory factors[tumor necrosis factor-α(TNF-α),white blood cell(WBC)count,neutrophil percentage(NE%),C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),and interleukin-1β(IL-1β)]and immune indicators(CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+))before and after treatment(i.e.after 5 d of treatment,same below)in both groups.Results①After treatment,the levels of serum amylase and serum lipase decreased in both groups(P<0.05),and the levels of serum amylase and lipase in the treatment group were lower than those in the control group(P<0.05).②After treatment,the levels of serum TNF-α,WBC count,NE%,CRP,IL-6,IL-8 and IL-1βdecreased in both groups(P<0.05);and the levels of serum TNF-α,CRP,IL-8 and IL-1βin the treatment group were lower than those in the control group(P<0.05).③After treatment,the serum levels of CD3^(+),CD4^(+)and CD8^(+),and the value of CD4^(+)/CD8^(+)increased in both groups(P<0.05);and the serum levels of CD3^(+)and CD4^(+)in the treatment group were higher than those in the control group(P<0.05).④During the trial,no significant adverse reactions were observed in both groups,and the treatment had good safety record.Conclusion The use of Chaihu Shugan Powder plus needling Zusanli(ST36)in addition to conventional medical treatment can better reduce the inflammatory response,regulate the immune status and promote the rec

关 键 词：急性胰腺炎 柴胡疏肝散 针刺 足三里 中西医结合疗法 临床试验 

分 类 号：R259[医药卫生—中西医结合]