基于“三才理论”的耳穴-外敷-灌肠治疗轻中型急性高脂血症性胰腺炎疗效观察  

Observation on Efficacy of Combination of“Ear Point-External Application-Enema”Based on“Sancai Theory”in Intervention of Mild to Moderate Acute Hyperlipidemic Pancreatitis

作　　者：居伟 周文明 JU Wei;ZHOU Wenming(Department of Gastroenterology,Suzhou High Tech Zone People’s Hospital,Suzhou 215129,China)

机构地区：[1]苏州市高新区人民医院消化内科,江苏苏州215129

出　　处：《山东中医杂志》2023年第12期1307-1313,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：江苏省卫生健康委员会科研项目(编号:Z2020018);苏州市医学重点扶持学科建设项目(编号:SZFCXK202110);苏州市卫健委科研课题项目(编号:SYSD2019231)。

摘　　要：目的:分析基于“三才理论”的耳穴-外敷-灌肠组合治疗轻中型急性高脂血症性胰腺炎的疗效。方法:选择轻中型急性高脂血症性胰腺炎96例,按随机数字表法分为灌肠组(A组)、外敷+灌肠组(B组)以及外敷+灌肠+耳穴组(C组)3组,各32例。在常规治疗的基础上,A组采用柴芍承气汤灌肠;B组在A组基础上加用改良芒硝袋外敷;C组在B组基础上采用子午流注耳部全息刮痧+揿针埋针耳穴方案。分析治疗前后3组炎症指标血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、胃肠动力学(排气恢复、腹胀缓解、腹痛缓解、肠鸣音恢复、排便恢复)、肠黏膜功能(内毒素、二胺氧化酶)、免疫功能(CD3+、CD4+、CD8+)、临床相关指标[Ranson评分、PACHEⅡ评分、甘油三酯(TG)水平]。结果:炎症指标,C组TNF-α、hs-CRP低于其余两组(P<0.05),而IL-6仅低于A组(P<0.05),与B组比较差异无统计学意义(P>0.05)。胃肠功能恢复时间,3组腹胀缓解时间比较,差异无统计学意义(P>0.05);在排气恢复、排便恢复时间及疼痛缓解时间,C组均显著少于其余两组(P<0.05);肠鸣音恢复时间,C组明显低于A组(P<0.05),与B组比较差异无统计学意义(P>0.05)。肠黏膜功能检测,C组内毒素、二胺氧化酶水平均低于其余两组(P<0.05)。免疫功能,C组CD3+、CD4+高于其余两组(P<0.05),CD8+3组差异无统计学意义(P>0.05)。临床相关指标,C组Ranson评分、PACHEⅡ评分均低于其余两组,差异有统计学意义(P<0.05),TG水平C组低于A组(P<0.05),与B组比较差异无统计学意义(P>0.05)。结论:基于“三才理论”的耳穴-外敷-灌肠组合方案治疗轻中型急性高脂血症性胰腺炎,可以降低炎症因子的表达,改善胃肠道功能,提高机体免疫力,疗效显著。Objective:To analyze efficacy of the combination of“ear point-external application-enema”based on the“Sancai theory”on mild to moderate acute hyperlipidemic pancreatitis.Method:Totally,96 patients with mild to moderate acute hyperlipidemic pancreatitis were selected and randomly divided into three groups according to the number table method:enema group(group A),external application+enema group(group B),and external application+enema+ear point group(group C),32 patients in each group.Besides routine treatment,group A was further treated with enema by Chaishao Chengqi Decoction(柴芍承气汤);group B was further treated with external application of mirabilite bags based on the treatment in group A;group C was further treated with holographic scraping on the ear of midnight-noon ebb-flow and embedded pressing needle embedding in ear points based on the treatment in group B.Three sets of inflammatory indicators before and after treatment,serum tumor necrosis factorα(TNF-α),interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP),gastrointestinal dynamics(recovery of exhaust,relief of abdominal distension,relief of abdominal pain,recovery of bowel sounds,and recovery of defecation),intestinal mucosal function(endotoxin,diamine oxidase),immune function(CD3+,CD4+,CD8+),clinical related indicators[Ranson score,acute physiology and chronic health evaluation(PACHE)Ⅱscore,triglyceride(TG)level].Results:As to inflammatory markers,group C was lower than other two groups on levels of TNF-αand Hs-CRP(P<0.05),and was lower than group A(P<0.05)with no difference compared to group B(P>0.05)on IL-6.There was no statistically significant difference in the recovery time of gastrointestinal function and the relief time of abdominal distension among the three groups(P>0.05).The recovery time of bloating,defecation,and pain relief in group C were significantly shorter than those in other two groups(P<0.05).The recovery time of intestinal sounds in group C was significantly lower than that in group A(P<0.05),with no d

关 键 词：三才理论 耳穴 芒硝外敷 灌肠 柴芍承气汤 急性高脂血症性胰腺炎 

分 类 号：R245.323[医药卫生—针灸推拿学]