摘要
目的探讨中药柴芍承气汤治疗重症急性胰腺炎（SAP）的作用机制。方法选择本院住院治疗的SAP患者30例，按随机数字表法分西医常规治疗组和加用柴芍承气汤中西医结合治疗组，每组15例。另以同期10例健康志愿者为健康对照组。采用双抗体夹心卵白素-生物素-过氧化物酶（ABC）-酶联免疫吸附试验（ELISA）测定患者于入院时及治疗3、5、7d血清白细胞介素（IL-6、IL-15）、巨噬细胞抑制因子（MIF）的含量，观察患者腹痛、腹胀、腹部压痛缓解、肠鸣音恢复时间及死亡情况。结果入院时两个治疗组SAP患者血清IL-6、IL-15、MIF浓度均显著高于健康对照组（均P〈0．05）；随治疗时间延长，上述指标呈下降趋势，以中西医结合组下降明显，并于治疗7d时达谷值，且与西医组同期比较差异有统计学意义[IL-6（ng／L）：246．34±86．65比724．88±110．89，IL-15（ng／L）：158．81±50．63比403．04±134．83，MIF（ng／L）：121．90±29．48比240．60±67．36，均P〈0．05]。中西医结合组肠道功能恢复时间较西医组显著缩短[腹痛缓解时间（h）：95．87±32．56比149．33±35．89，腹胀缓解时间（h）：137．07±41．67比191．87±32．08，腹部压痛缓解时间（h）：128．93±40．60比189．73±33．31，肠鸣音恢复时间（h）：88．53±31．71比128．00±30．92，均P〈0．05]。西医组死亡2例，中西医结合组无死亡，但两组比较差异无统计学意义（P〉O．05）。结论中药柴芍承气汤结合常规西医方法治疗SAP疗效优于单纯西医治疗，其作用机制可能与降低血清IL-6、IL-15和MIF水平有关。
Objective To investigate the effect of chai shao cheng qi decoction on inflammation mediators in patients with severe acute pancreatitis （SAP）. Methods Thirty patients with SAP were randomly divided into two groups, western medicine group and integrative traditional Chinese medicine （TCM） and western medicine therapy group. Ten healthy volunteers were enrolled in the healthy control group. Double-antibody sandwich avidin- biotin-peroxisome complex （ABC）-enzyme-linked immunosorbent assay （ELISA）was used to detect the levels of serum interleukin-6 （IL-6）, interleukin- 15 （IL- 15 ） and macrophage migration inhibitory factor （MIF） at the time of admission and after admission 3,5 and 7 days. The times of local symptom relief of abdominal pain, distension and abdominal tenderness, bowel sound recovery and death were observed. Results The serum concentrations of IL-6, IL-15 and MIF of two treatment groups at the time of admission were significantly higher than those in healthy control group （all P〈 0.05 ）, but there were no significant differences between the two groups （P 〉 0.05 ）. With the prolongation of treatment, the serum levels of above indexes were all reduced after treatment in two groups, the lowest levels being at the time point 7th day in both groups and compared at all the same time points the levels in integrative medicine therapy group being lower than those in western medicine group [ IL-6 （rig/L） ： 246.34 ＋ 86.65 vs. 724.88 ＋ 110.89, IL-15 （ng/L） ： 158.81 ＋50.63 vs. 403.04＋ 134.83, MIF （ng/L） ： 121.90＋29.48 vs. 240.60＋67.36, all P〈0.05]. The serum concentrations of MIF in integrative medicine therapy group were significantly lower than those in western medicine group after admission 5 days and 7 days （both P〈 0.05 ） . The recovery times of intestinal tract functions in integrative medicine therapy group were much shorter than those in western medicine group [ local symptom relief of abdominal pain （hour） ： 95.87 ＋ 32.56 vs. 149.33 ＋ 35.89 ; distension （hour） ： 137.07 ＋ 41.67 vs. 191.87 ＋ 32.08 ; abdominal tenderness （hour）： 128.93±40.60 vs. 189.73＋33.31; bowel sound recovery （hour）： 88.53＋31.71 vs. 128.00＋30.92, all P〈0.05]. There were 2 patients dead in western medicine group, and non in integrative medicine therapy group, but between the two groups there was no difference in mortality statistically significant （P 〉 0.05）. Conclusion The therapeutic effect of integrative TCM and western medicine therapy for treatment of SAP is superior to that of the western medicine alone： The mechanism of action of chai shao eheng qi TCM decoction is likely to be concerned with the reduction of serum levels of IL-6, IL-15 and MIF.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2013年第3期138-141,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
四川省医药卫生科研基金资助项目（050062）
关键词
急性胰腺炎
重症
中西医结合疗法
白细胞介素-6
白细胞介素-15
巨噬细胞抑制因子
柴芍承气汤
Severe acute pancreatitis
Integrated traditional Chinese and western medicine therapy
Interleukin-6
Interleukin-15
Macrophage migration inhibitory factor
Chai shao cheng qi decoction
作者简介
通信作者：冯志松，Email：fengzhisong@medmail．com
