清热通腑化瘀方结合血液净化治疗急性胰腺炎的疗效分析  

Therapeutic effect of Qingre Tongfu Huayu Formula combined with blood purification on acute pancreatitis

作　　者：周哲 平立英 郑洋 许长庆 ZHOU Zhe;PING Liying;ZHENG Yang;XU Changqing(Department of Emergency,the Third Hospital of Xingtai,Xingtai,Hebei,054000,China;Department of Nephrology,the Third Hospital of Xingtai;Department of Gastroenterology,the Third Hospital of Xingtai)

机构地区：[1]邢台市第三医院急诊科,河北邢台054000 [2]邢台市第三医院肾内科 [3]邢台市第三医院消化内科

出　　处：《中国中西医结合消化杂志》2023年第7期567-572,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：邢台市科技计划项目(No:2019ZC210)。

摘　　要：目的探讨清热通腑化瘀方结合血液净化治疗急性胰腺炎患者的疗效,及对肠道微生态、胃电图参数及血清巨噬细胞炎性蛋白-1α(macrophage inflammatory protein-1α,MIP-1α)、钙黏蛋白E(E-cadherin)的影响。方法选择2020年5月-2022年5月收治的148例急性胰腺炎患者为研究对象,按照随机数字表法分为观察组和对照组,每组各74例。对照组接受常规西医治疗以及血液净化,观察组在对照组基础上接受清热通腑化瘀方治疗。比较两种治疗方式的疗效、中医证候积分、肠道微生态、胃电图参数及对患者血清MIP-1α、E-cadherin水平的影响。结果观察组患者治疗后的有效率高于对照组(91.89%vs 79.73%),差异有统计学意义(P<0.05)。观察组患者的症状(腹痛、腹胀、肠鸣音)以及实验室指标(血常规、血淀粉酶、尿淀粉酶)改善时间均短于对照组,差异有统计学意义(P<0.05)。治疗后两组患者的中医证候(恶心呕吐、上腹疼痛、黄疸、发热、脉细或滑数、舌红苔白薄)积分均明显降低,其中观察组患者治疗后的积分均低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的D-乳酸、血淀粉酶、二胺氧化酶以及肠杆菌、肠球菌水平均降低,而双歧杆菌、乳杆菌水平均增加,其中观察组的改善程度优于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的胃电图平均频率、主频率以及振幅均有增加趋势,其中观察组治疗后胃电参数高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后血清MIP-1α、E-cadherin水平均明显降低,其中观察组患者治疗后血清MIP-1α、E-cadherin水平低于对照组,差异有统计学意义(P<0.05)。结论清热通腑化瘀方结合血液净化治疗急性胰腺炎效果较好,可加快患者的症状恢复,改善胃肠道生理状态以及肠道微生态,降低血清MIP-1α、E-cadherin水平,且安全性较好,值得临床推广。Objective To investigate the efficacy of Qingre Tongfu Huayu Formula combined with blood purification in the treatment of acute pancreatitis,and its effects on intestinal microecology,gastric electroparameters,serum macrophage inflammatory protein-1α(MIP-1α)and E-cadherin.Methods One hundred and forty-eight patients with acute pancreatitis admitted from May 2020 to May 2022 were selected and divided into the observation group and the control group according to random number table method,with 74 cases in each group.The control group received conventional Western medicine treatment and blood purification,and the observation group received Qingre Tongfu Huayu Formula on the basis of the control group.The efficacy,Traditional Chinese Medicine syndrome score,intestinal microecology,electrogastrogram parameters and their effects on serum MIP-1αand E-cadherin were compared between the two treatments.Results The effective rate of the observation group was higher than that of the control group(91.89%vs 79.73%),the difference was statistically significant(P<0.05).The improvement time of symptoms(abdominal pain,abdominal distension,intestinal sound)and laboratory indicators(blood image,blood amylase,urine amylase)in the observation group was shorter than that in the control group(P<0.05).After treatment,the scores of the main syndroms(nausea and vomiting,epigastric pain,jaundice,fever,thin or smooth pulse,red tongue,and thin tongue)of the two groups were significantly decreased,and the scores of the observation group were lower than those of the control group(P<0.05).After treatment,the levels of D-lactic acid,blood amylase,Enterobacterium,and Enterococcus were decreased in two groups,while the levels of bifidobacterium and Lactobacillus were increased,and the improvement degree of the observation group was better than the control group(P<0.05).After treatment,FP,FZ and AP in the two groups showed an increasing trend,and the gastric electrical parameters in the observation group were higher than those in the control grou

关 键 词：血液透析 清热通腑化瘀方 急性胰腺炎 肠道微生态 胃电图 巨噬细胞炎性蛋白-1Α 钙黏蛋白E 

分 类 号：R657.51[医药卫生—外科学]