摘要
目的:观察大黄牡丹汤灌肠联合西药治疗急性胰腺炎的临床疗效。方法:采用随机数字表法将144例急性胰腺炎患者分为对照组、治疗组各72例。对照组给予乌司他丁联合生长抑素治疗,治疗组在对照组基础上加用大黄牡丹汤灌肠治疗,2组连续治疗10 d。比较2组临床疗效、临床症状消失时间、不良反应发生率;比较2组治疗前后中医证候积分、血清淀粉酶、脂肪酶、炎症因子水平及外周血T淋巴细胞指标(Th1、Th2、Th17、Treg、Th1/Th2、Th17/Treg)。结果:治疗后,治疗组总有效率98.61%,高于对照组88.89%(P<0.05);治疗组腹胀症状消失时间、腹痛症状消失时间、腹膜刺激征症状消失时间均短于对照组(P<0.05)。治疗后,2组中医证候积分、血清淀粉酶、脂肪酶、干扰素-γ(IFN-γ)、白细胞介素(IL)-17、外周血Th1、Th17水平及Th1/Th2、Th17/Treg均较治疗前降低(P<0.05);治疗组治疗后上述指标均低于对照组(P<0.05)。治疗后,2组血清IL-4、转化生长因子-β(TGF-β)水平及外周血Th2、Treg水平均较治疗前升高(P<0.05);治疗组治疗后血清IL-4、TGF-β水平及外周血Th2、Treg水平高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:大黄牡丹汤灌肠联合西药治疗急性胰腺炎,临床疗效显著,能够调节患者Th1/Th2、Th17/Treg细胞平衡,减轻炎症反应,安全性较高。
Objective:To observe the clinical effect of enema with Dahuang Mudan Decoction combined with western medicine for acute pancreatitis.Methods:A total of 144 cases of patients with acute pancreatitis were divided into the control group and the treatment group according to the random number table method,with 72 cases in each group.The control group was treated with Ulinastatin combined with Somatostatin,and the treatment group was additionally treated with the enema with Dahuang Mudan Decoction based on the treatment of the control group.The two groups were continuously treated for 10 days.Clinical effects,the disappearance time of clinical symptoms,and the incidence of adverse reactions were compared between the two groups.Traditional Chinese medicine(TCM)syndrome scores,serum amylase,lipase,inflammatory factor levels,and peripheral blood T lymphocytes(Th1,Th2,Th17,Treg,Th1/Th2,and Th17/Treg)were compared between the two groups before and after treatment.Results:After treatment,the total effective rate was 98.61%in the treatment group,higher than that of 88.89%in the control group(P<0.05);the disappearance time of symptoms of abdominal distension,abdominal pain,and peritoneal irritation signs in the treatment group was shorter than that in the control group(P<0.05).After treatment,TCM syndrome scores,serum amylase,lipase,interferon-γ(IFN-γ),interleukin(IL)-17,the levels of Th1 and TH17 in peripheral blood,Th1/Th2,and Th17/Treg in the two groups were decreased when compared with those before treatment(P<0.05);after treatment,the above indicators in the treatment group were lower than those in the control group(P<0.05).After treatment,the levels of IL-4 and transforming growth factor-β(TGF-β)in serum as well as the levels of Th2 and Treg in peripheral blood in the two groups were increased when compared with those before treatment(P<0.05);after treatment,the levels of IL-4 and TGF-βin serum as well as the levels of Th2 and Treg in peripheral blood in the treatment group were higher than those in the control group(P<0.05).There was no significant difference being found in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Enema with Dahuang Mudan Decoction combined with western medicine has significant clinical effects in the treatment of acute pancreatitis,which can regulate the balance of Th1/Th2 and Th17/Treg cells in patients,alleviate inflammatory reactions,and have high safety.
作者
房相娟
郑喜胜
李长力
FANG Xiangjuan;ZHENG Xisheng;LI Changli(Department of Pharmaceutical Sciences,Nanyang Central Hospital,Nanyang Henan 473000,China;Department of Intensive Care Medicine,Nanyang Central Hospital,Nanyang Henan 473000,China)
出处
《新中医》
CAS
2024年第11期12-16,共5页
New Chinese Medicine
作者简介
房相娟(1991-),女,主管药师,E-mail:z18460100@sina.com。;通信作者:郑喜胜(1975-),男,医学硕士,主任医师,硕士研究生导师,E-mail:1286826369@qq.com。
