摘要
目的探讨柴芍承气汤治疗重症急性胰腺炎合并急性肠功能衰竭的疗效及对重症急性胰腺炎预后的影响及其机制。方法把98例重症急性胰腺炎合并急性肠功能衰竭患者,随机分为对照组(40例)和治疗组(58例),对照组给予常规治疗,治疗组在常规治疗的基础上加用柴芍承气汤,分别观察腹胀持续时间、第1次排大便时间、平均住院天数、胰腺脓肿发生率及治疗72 h后血内毒素(ET)、胃动素(MTL)、IL-1、IL-6、TNFα水平。结果治疗组腹胀持续时间为(40.5±15.7)h,对照组为(140.3±30.8)h (P<0.01);第一次排便时间治疗组(35.5±15.7)h,对照组为(130.3±30.8)h(P<0.01);治疗组住院(10.8±3.5)d,对照组住院(18.1±8.2)d(P<0.05);对照组出现胰腺周围脓肿3例,其中1例死亡,治疗组无胰腺脓肿并发症发生,无死亡病例;治疗72 h后血清内毒素水平治疗组(0.045±0.011)EU/L较对照组(O.087±0.012)EU/L显著降低,治疗组血浆MTL(0.38±0.13)ng/ml高于对照组(0.14±0.08)ng/ml,治疗组血浆IL-1、IL-6、TNFα水平(0.45±0.05、4.25±0.35、45.83±4.91)ng/ml均较对照组(0.67±0.10、7.56±0.62、88.74±5.40)ng/ml显著降低。结论柴芍承气汤能促进重症急性胰腺炎合并急性肠功能衰竭患者肠道功能恢复,缩短住院时间,增加血MTL水平,降低血浆内毒素及血清细胞因子和炎症介质水平,降低胰腺脓肿发生率。
Objective To investigate the effect of Chaishac Chengqi Decoction in intestinal failure complicated with severe acute pancreatitis （SAP） and of the prognosis of SAP as well as the mechanism. Methods 98 patients with intestinal failure complicated with SAP were divided into control group （n =40 ） and treatment group （n = 58 ） randomly. The conventional managements were given to control group while Chaishao Chengqi Decoction was given to treatment group besides conventional managements. The duration of abdominal distention ,the time of the first bowel, the days in hospital, the incidence of pancreatic abscess, and the blood level of ET, MTL, IL-1, IL-6 and TNFα were observed. Results The remission duration of abdominal distention was （40.5 ± 15.7 ） h in treatment group and （ 140.3 ± 30.8 ） h in control group （ P 〈 0.01 ）, the time of the first bowel was （ 35.5 ± 15.7 ） h in treatment group and （ 130.3± 30.8 ） h in control group （ P 〈 0.01 ） and the days in hospital were （ 10.8 ± 3.5 ） d in treatment group and （18.1 ± 8.2 ）d in control group （P 〈 0.05 ）. Peripancreatic abscess occurred in 3 cases of control group, 1 of whom died, but it did not occur in treatment group. The endotoxin level was significantly decreased in treatment group （0.045 ±0.011 ） EU/L as compared with those of control group （ 0. 087 ± 0.012 ） EU/L after 72h treatment. The MTL level of treatment group was higher than that of control group[ （0.38±0.13 ） ng/ml vs （0.14 ± 0.08 ） ng/ml ]. The blood level of IL-1, IL-6 and TNFct of treatment group [ （0.45 ± 0.05,4.25 ± 0.35,45.83 ± 4.91 ） ng/ml ] were significantly lower than those of control group [ （ 0.67± 0.10,7.56 ± 0.62,88.74± 5.40 ） ng/ml ]. Conclusion Chaishac Chengqi Decoction can promote remission of the gastrointestinal function, increase the MTL blood level, decrease the blood level of ET,IL-1 ,IL-6 and TNFα in intestinal failure complicated with SAP and decrease the incidence of pancreatic abscess.
出处
《中国医药》
2007年第7期402-404,共3页
China Medicine
关键词
柴芍承气汤
重症急性胰腺炎
急性肠功能衰竭
Chaishac Chengqi Decoction
Severe acute pancreatitis
Acute intestinal failure
