临时小口径胰管支架置入联合清胰通腑汤治疗胆源性急性复发性胰腺炎的效果  

Effect of temporary small caliber pancreatic duct stenting combined with Qingyi Tongfu decoction in the treatment of biliary acute recurrent pancreatitis

作　　者：郝余庆 蒋徐维 丁俊[2] HAO Yuqing;JIANG Xuwei;DING Jun(Department of Hepatobiliary Surgery,Baoshan Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201900,China;Department of Hepatobiliary and Pancreatic Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海市宝山区中西医结合医院肝胆外科,上海201900 [2]上海中医药大学附属曙光医院肝胆胰外科,上海201203

出　　处：《长春中医药大学学报》2024年第2期189-192,共4页Journal of Changchun University of Chinese Medicine

基　　金：上海市自然科学基金项目(19ZR1438100)。

摘　　要：目的观察临时小口径胰管支架置入联合清胰通腑汤治疗胆源性急性复发性胰腺炎(ARP)的临床效果。方法选择胆源性急性复发性胰腺炎患者78例,随机数表法分为对照组(给予临时小口径胰管支架置入治疗)和观察组(给予临时小口径胰管支架置入+清胰通腑汤治疗),各39例。比较2组中医症状评分、急性生理与慢性健康评分(APACHEⅡ)、急性胰腺炎床边指数(BISAP)、血清淀粉酶(AMS)与肝功能指标丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸(ALP)及总胆红素(TBIL)、炎症因子水平降钙素原(PCT)、白细胞介素-1β(IL-1β)。随访1年,统计2组死亡率和复发率。结果治疗后,观察组主症、次症评分及总分均低于对照组(P<0.05)。观察组治疗后APACHEⅡ、BISAP评分均低于对照组(P<0.05)。观察组治疗后AMS、ALT、AST、ALP、TBIL低于对照组(P<0.05)。治疗后,观察组PCT、IL-1β低于对照组(P<0.05)。随访1年,2组死亡率比较,差异无统计学意义(P>0.05);观察组复发率低于对照组(P<0.05)。结论临时小口径胰管支架置入联合清胰通腑汤治疗胆源性急性复发性胰腺炎可缓解患者临床症状,降低病情严重程度和胰腺损伤,改善AMS和肝功能指标,调节炎性因子水平,并可降低复发率。Objective To observe the clinical effect of temporary small caliber pancreatic duct stenting combined with Qingyi Tongfu decoction in the treatment of biliary acute recurrent pancreatitis(ARP).Methods 78 patients with biliary ARP were selected and divided into the control group and the observation group according to random number table method,with 39 cases in each group.The control group was treated with temporary small caliber pancreatic duct stenting,and the observation group was treated with temporary small caliber pancreatic duct stenting and Qingyi Tongfu decoction.The traditional Chinese medicine(TCM)symptom score,acute physiology and chronic health evaluation(APACHE I),bedside index of severity acute pancreatitis(BISAP),serum amylase(AMS),the levels of liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphate(ALP)and total bilirubin(TBIL)],and the levels of inflammatory factors[procalcitonin(PCT)and interleukin-1β(IL-1B)]between two groups were compared.The mortality and recurrence rate of two groups were calculated after 1 year of followup.Results After treatment,the scores of main symptoms and secondary symptoms,and total scores in the observation group were lower than those in the control group(P<0.05).After treatment,APACHE II and BISAP scores in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of AMS,ALT,AST,ALP and TBIL in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of PCT and IL-1β in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in mortality between two groups after 1 year of follow-up(P>0.05).The recurrence rate in the observation group was lower than that in the control group(P<0.05).Conclusion Temporary small caliber pancreatic duct stenting combined with Qingyi Tongfu decoction can alleviate the clinical symptoms of patients with biliary ARP,reduce the severity of th

关 键 词：急性胰腺炎 中医 疗效 胆源性急性胰腺炎 

分 类 号：R657.5[医药卫生—外科学]