摘要
目的考察通腑解毒方联合大承气汤保留灌肠和常规治疗对急性胰腺炎患者的临床疗效。方法130例患者随机分为对照组和观察组,每组65例,对照组采用常规治疗(埃索美拉唑钠、乌司他丁、美罗培南),观察组在对照组基础上加用通腑解毒方联合大承气汤保留灌肠,疗程7 d。检测临床疗效、肠功能屏障指标(内毒素、DAO)、胰腺体部血流指标(BF、PS、BV)、血尿淀粉酶、炎症因子(IL-1、IL-18、CRP)、中医证候评分、预后变化。结果观察组总有效率高于对照组(P<0.05),并发症发生率更低(P<0.05)。治疗后,2组BF、BV升高(P<0.05),PS、肠功能屏障指标、血尿淀粉酶、炎症因子、中医证候评分降低(P<0.05),以观察组更明显(P<0.05)。2组手术中转率、病死率比较,差异无统计学意义(P>0.05)。结论通腑解毒方联合大承气汤保留灌肠和常规治疗可降低急性胰腺炎患者血尿淀粉酶表达和并发症发生,减轻炎症反应,改善肠功能屏障指标和胰腺体部血流动力学。
AIM To investigate the clinical effects of Tongfu Jiedu Recipe combined with retention enema of Dachengqi Decoction and conventional treatment on patients with acute pancreatitis. METHODS One hundred and thirty patients were randomly assigned into control group(65 cases) for 7-day intervention of conventional treatment(esomeprazole sodium, urinastatin, meropenem), and observation group(65 cases) for 7-day intervention of Tongfu Jiedu Recipe, retention enema of Dachengqi Decoction and conventional treatment. The changes in clinical efficacy, intestinal functional barrier indices(endotoxin, DAO), blood flow indices in pancreatic body(BF, PS, BV), blood and urine amylases, inflammatory factors(IL-1, IL-18, CRP), TCM syndrome scores and prognosis were detected. RESULTS The observation group demonstrated higher total effective rate than the control group(P<0.05), along with lower incidence of complications(P<0.05). After the treatment, the two groups displayed increased BF and BV(P<0.05), and decreased PS, intestinal functional barrier indices, blood and urine amylases, inflammatory factors and TCM syndrome scores(P<0.05), especially for the observation group(P<0.05). No significant differences in conversion rate of operation and case fatality rate were found between the two groups(P>0.05). CONCLUSION For the patients with acute pancreatitis, Tongfu Jiedu Recipe combined with retention enema of Dachengqi Decoction and conventional treatment can reduce expressions of blood and urine amylase and incidence of complications, alleviate inflammatory responses, and improve intestinal functional barrier indices and hemodynamics in pancreatic body.
作者
潘华
叶文冲
戴家超
杨卫生
PAN Hua;YE Wen-chong;DAI Jia-chao;YANG Wei-sheng(Department of Traditional Chinese Medicine,The Second People’s Hospital of Jingdezhen,Jingdezhen 333000,China)
出处
《中成药》
CAS
CSCD
北大核心
2022年第3期776-780,共5页
Chinese Traditional Patent Medicine
基金
江西省科技计划项目(2014ZBBG70007)。
关键词
通腑解毒方
大承气汤
保留灌肠
常规治疗
急性胰腺炎
Tongfu Jiedu Recipe
Dachengqi Decoction
retention enema
conventional treatment
acute pancreatitis
作者简介
潘华(1964—),男,副主任医师,研究方向为中医内科。Tel:13879871280,E-mail:mba88ba@126.com。
