清胰通腑汤内服联合芒硝外敷对急性胰腺炎患者肠黏膜屏障功能、胰腺功能和炎症的影响  

Effects of Oral Administration of Qingyi Tongfu Decoction Combined with External Application of Mirabilite on Intestinal Mucosal Barrier Function,Pancreatic Function and Inflammation in Patients with Acute Pancreatitis

作　　者：李敏 甘淳[2] LI Min;GAN Chun(Department of Integrative Medicine,Xinyu People's Hospital,Xinyu 338025,China;不详)

机构地区：[1]新余市人民医院中西医结合科,江西新余338025 [2]江西中医药大学附属医院国医堂,江西南昌330000

出　　处：《中国医学创新》2025年第6期10-16,共7页Medical Innovation of China

基　　金：江西省第四批中医药中青年骨干人才培养计划项目[赣中医药科教涵(2022)6号];江西省新余市科技计划项目(20233090816)。

摘　　要：目的:观察清胰通腑汤内服联合芒硝外敷中脘穴治疗急性胰腺炎的临床效果及对肠黏膜屏障功能的影响。方法:选取2022年1月—2023年1月新余市人民医院收治的急性胰腺炎患者78例,采用随机数字表法按1∶1比例将纳入的78例患者分为两组,对照组予常规内科治疗,治疗组加用清胰通腑汤内服联合芒硝外敷中脘穴治疗,治疗2周。评价两组临床疗效、中医证候评分、胰腺功能(血淀粉酶、脂肪酶)、炎症反应指标[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平]、肠黏膜屏障功能相关指标[包括内毒素、D-乳酸和二胺氧化酶(DAO)]、不良反应发生情况。结果:治疗后治疗组总有效率为97.44%,对照组为89.74%,治疗组总有效率明显更高(P<0.05)。治疗后两组主症评分、次症评分和总分、胰腺功能指标、炎症反应指标、肠黏膜屏障功能指标水平均较治疗前降低(P<0.05),且治疗组均较对照组低(P<0.05)。结论:加用清胰通腑汤内服联合芒硝外敷中脘穴治疗急性胰腺炎能提高临床效果,显著改善临床症状,其作用机制可能涉及抑制机体炎症、修复和恢复肠黏膜屏障功能。Objective:To observe the clinical effect of oral administration of Qingyi Tongfu Decoction combined with Mirabilite applied to Zhongwan point in the treatment of acute pancreatitis and its effect on intestinal mucosal barrier function.Method:A total of 78 acute pancreatitis patients admitted to Xinyu People's Hospital from January 2022 to January 2023 were selected and divided into two groups by random number method according to the ratio of 1∶1.The control group was given conventional medical treatment,and the treatment group was treated with Qingyi Tongfu Decoction combined with Mirabilite applied to Zhongwan point for 2 weeks.Clinical efficacy,TCM syndrome score,pancreatic function(amylase,lipase),inflammatory response indexes(CRP,PCT,IL-6 and TNF-α),intestinal mucosal barrier function indexes[endotoxin,D-lactic acid and diamine oxidase(DAO)],and occurrence of adverse reactions were evaluated in the two groups.Result:After treatment,the total effective rate was 97.44%in the treatment group and 89.74%in the control group,and the total effective rate was significantly higher in the treatment group(P<0.05).After treatment,the main disease score,secondary disease score and total score,pancreatic function indexes,inflammatory response indexes and intestinal mucosal barrier function indexes of both groups were lower than those before treatment(P<0.05),and those in the treatment group were lower than those in the control group(P<0.05).Conclusion:Qingyi Tongfu Decoction combined with Mirabilite applied to Zhongwan point can improve clinical efficacy and symptoms in the treatment of acute pancreatitis,and its mechanism may be related to reducing inflammation and repairing intestinal mucosal barrier function.

关 键 词：胰腺炎 通腑 中药疗法 芒硝外敷 

分 类 号：R576[医药卫生—消化系统]