摘要
目的探讨中药红藤汤联合抗菌素在阑尾周围脓肿中的治疗作用及可能免疫学机制.方法宁波市北仑区人民医院普外科2014-01/2017-04期间收治的68例阑尾周围脓肿患者按信封法随机分为两组,即抗菌素常规治疗组(31例)和中药红藤汤联合抗菌素治疗组(37例),分析比较两组症状消失时间、体征消失时间、住院时间、治疗第10天脓肿消失率、脓肿穿刺引流率等.用酶联免疫吸附试验检测患者治疗前、治疗第4天、第8天外周血细胞因子白介素(interleukin,IL)-6、IL-10及肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)水平并比较.结果红藤汤联合抗菌素治疗组症状消失时间、体征消失时间及住院时间均较抗菌素常规治疗组明显缩短,差异有统计学意义(P<0.05).红藤汤联合抗菌素治疗组治疗第10天脓肿消失率显著高于抗菌素常规治疗组(91.89%vs 70.97%,P<0.05),脓肿穿刺引流率显著低于抗菌素常规治疗组,差异有统计学意义(5.41%vs 22.58%,P<0.05).两组患者外周血中IL-6及TNF-α水平均较治疗前显著降低(P<0.01),红藤汤联合抗菌素组治疗第4天、第8天IL-6及TNF-α水平均较单纯抗菌素组下降明显(P<0.05).单纯抗菌素组第8天IL-10水平显著高于治疗前和红藤汤联合抗菌素组同期水平(P<0.05).结论中药红藤汤联合抗菌素治疗阑尾周围脓肿能显著促进脓肿吸收消散,缩短住院时间,治疗效果显著,其可能通过降低血清IL-6、TNF-α水平发挥作用.
AIM To evaluate the therapeutic effect of combined Hongteng decoction and antibiotic therapy in the treatment of periappendiceal abscess and to explore the possible immune mechanism.METHODS Sixty-eight patients with periappendiceal abscess treated at the Department of General Surgery of Beilun District People＇s Hospital between January 2014 and April 2017 were randomly divided into two groups to receive either routine antibiotic therapy alone （n = 31） or combined Hongteng decoction and routine antibiotic therapy （n = 37）. Time to disappearance of symptoms and signs, length of hospital stay, the rate of periappendiceal abscess disappearance 10 d after treatment, and the rate of percutaneous puncture and catheter drainage were compared between the two groups. Serum levels of Interleukin-6 （IL-6）, IL-10, and tumor necrosis factor α （TNF-α） were assessed by enzyme-linked immunosorbent assay before treatment and 4 d and 8 d after treatment.Time to disappearance of symptoms and signs and length of hospital stay in the combination group were significantly shorter than those in the routine antibiotic group （P 〈 0.05）. The rate of periappendiceal abscess disappearance 10 d after treatment in the combination group was significantly higher than that in the routine antibiotic group （91.89% vs 70.97%, P 〈 0.05）. The rate of percutaneous puncture and catheter drainage in the combination group was significantly lower than that in the routine antibiotic group （5.41% vs 22.58%, P 〈0.05）. The levels of IL-6 and TNF-c~ in both groups after treatment were significantly lower than those before treatment （P 〈 0.01）, and these levels at 4 d and 8 d after treatment were significantly lower in the combination group than in the routine antibiotic group （P 〈 0.05）. The level of IL-10 at 8 d after treatment in the routine antibiotic group was significantly higher than that before treatment and that in the combination group at the same time point （P 〈 0.05）.CONCLUSION The combination of Hongteng decoction and antibiotic therapy can effectively promote the absorption of abscess, shorten hospital stay, and result in a significant therapeutic effect by reducing the serum levels of IL-6 and TNF-c~ in patients with periappendiceal abscess.
作者
朱林波
李鹏飞
张鹏斌
Lin-Bo Zhu;Peng-Fei Li;Peng-Bin Zhang(Department of General Surgery, Beilun District People＇s Hospital, Ningbo 315800, Zhejiang Province, China)
出处
《世界华人消化杂志》
CAS
2018年第9期575-580,共6页
World Chinese Journal of Digestology
关键词
红藤汤
阑尾周围脓肿
细胞因子
Hongteng decoction
Periappendiceal abscess
Cytokine
作者简介
朱林波，主治医师，主要从事普通外科常见病、多发病的诊治及临床研究;通讯作者：李鹏飞，主任医师，315800，浙江省亍波市北仑区庐山东路1288号，宁波市北仑区人民医院普外科Ipf554171@163．com电话：0574—86776581
