解毒通胰汤保留灌肠联合常规疗法治疗高脂血症性重症急性胰腺炎临床研究  

Clinical Study on Retention Enema with Jiedu Tongyi Decoction Combined with Routine Therapy for Hyperlipidemic Severe Acute Pancreatitis

作　　者：焦鹏[1] 申霖[1] 翟盈盈 罗常月[1] JIAO Peng;SHEN Lin;ZHAI Yingying;LUO Changyue

机构地区：[1]商丘市第一人民医院,河南商丘476000

出　　处：《新中医》2023年第12期47-52,共6页New Chinese Medicine

摘　　要：目的:观察解毒通胰汤保留灌肠联合常规疗法治疗高脂血症性重症急性胰腺炎的临床疗效。方法:选取88例高脂血症性重症急性胰腺炎瘀毒互结证患者,随机分为对照组和观察组。2组均予常规治疗方案,观察组加用解毒通胰汤保留灌肠。2组均治疗10 d。治疗前后评定2组患者的急性生理与慢性健康评分表(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分,检测血清淀粉酶(AMS)、肠黏膜屏障功能指标[内毒素、D-乳酸、二胺氧化酶(DAO)]、炎症因子指标[细胞间黏附分子-1 (ICAM-1)、白细胞介素-6 (IL-6)、降钙素原(PCT)],比较2组临床疗效,观察患者症状、体征的变化情况及不良反应的发生情况。结果:治疗后,观察组总有效率92.86%,对照组总有效率76.19%,2组总有效率比较,差异有统计学意义(P<0.05)。观察组腹胀持续时间、腹痛持续时间均较对照组缩短,首次排气排便时间较对照组提早,差异均有统计学意义(P<0.05)。2组APACHEⅡ评分、SOFA评分及内毒素、D-乳酸、DAO、AMS、SAA、ICAM-1、PCT、IL-6水平均较治疗前降低(P<0.05);观察组以上指标值均低于对照组(P<0.05)。治疗期间,2组患者均无明显不良反应发生。结论:采用解毒通胰汤保留灌肠联合常规疗法治疗高脂血症性重症急性胰腺炎具有良好临床疗效,可有效改善患者的临床症状和体征,维护肠黏膜屏障功能,抑制炎症反应,安全性高。Objective:To observe the clinical effect of therapy of retention enema with Jiedu Tongyi Decoction combined with routine therapy on hyperlipidemic severe acute pancreatitis.Methods:A total of 88 patients with hyperlipidemic severe acute pancreatitis with syndrome of intermingled blood stasis and toxin were selected and randomly divided into the control group and the observation group.The two groups were given routine therapy,and the observation group was additionally treated with retention enema with Jiedu Tongyi Decoction.The two groups were treated for ten days.Before and after treatment,the scores of Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)and Sequential Organ Failure Assessment(SOFA)in both groups were evaluated;the serum amylase(AMS)and the indexes of intestinal mucosal barrier function,including endotoxin,D-lactic acid and diamine oxidase(DAO),and of inflammatory factors,including intercellular cell adhesion molecule- 1 (ICAM- 1),interleukin- 6 (IL- 6) and procalcitonin(PCT) were detected;the clinical effects were compared between the two groups;the changes ofsymptoms and signs of patients and the incidence of adverse reactions were observed. Results: Aftertreatment,the total effective rate was 92.86% in the observation group and 76.19% in the control group,the difference being significant (P<0.05). The duration of abdominal distention and abdominal pain in theobservation group were shortened when compared with those in the control group,and the first exhausttime and first defecation time were earlier than those in the control group,differences being significant (P<0.05). The APACHEⅡscores,SOFA scores and levels of endotoxin,D- lactic acid,DAO,AMS,SAA,ICAM- 1,PCT and IL- 6 in the two groups were decreased when compared with those before treatment(P<0.05);the above two scores and seven levels in the observation group were lower than those in thecontrol group (P<0.05). There were no significant adverse reactions in the two groups during treatment.Conclusion: The therapy of retention enem

关 键 词：重症急性胰腺炎 高脂血症 瘀毒互结证 解毒通胰汤 中药保留灌肠 肠黏膜屏障功能 炎症反应 

分 类 号：R576[医药卫生—消化系统]