内镜结合中医疗法治疗重症急性胰腺炎对细胞因子的影响

Influence on serum cytokines in patientes with severe acute pancreatitis treated by endoscopic therapy combined with traditional Chinese medicine

[目的]研究内镜结合中医疗法治疗重症急性胰腺炎(SAP)对患者血浆细胞因子及住院时间、病死率的影响。[方法]动态观察内镜结合中医疗法治疗SAP前、后血浆白细胞介素6(IL-6)I、L-8I、L-1β、肿瘤坏死因子-α(TNF-α)、内毒素(LPS)的变化及住院天数和病死率;以同期中西医结合疗法治疗SAP患者作对照。[结果]内镜结合中医疗法及中西医结合治疗均可降低血浆IL-6I、L-8、IL-1β、TNF-α、LPS,但内镜结合中医疗法治疗后血浆IL-6、IL-8I、L-1β、TNF-α、LPS下降较快(P<0.01、<0.05、<0.05、<0.01、<0.01)。住院时间缩短,病死率2组差异无统计学意义(P>0.05)。[结论]内镜结合中医疗法治疗效果与解除下端胆管梗阻、降低血浆细胞因子有关。

[Objective] To explore the influence of endoscopy combined with Chinese medicine on serum cytokines, length of stay （LOS） and case-fatality rate （CFR） of patients with SAP. [Methods] The serum levels of IL-6, IL-8, IL-1β, TNF-α and lipopolysaccharide （LPS） in the SAP patients were assayed respectively before and after 1, 5, 7, 14 days＇ therapy, and LOS and CFR were evaluated. [Results] Both endoscopy combined with the Chinese medicine and west drugs combined with Chinese medicine decreased the serum level of IL-6, IL-8, IL-1β, TNF-α and LPS. The level of IL-6, IL-8, IL-1β, TNF-α, LPS in the serum of the group of endoscopy therapy combined with the traditional Chinese medicine fell more rapidly than that of the traditional Chinese medicine combined with west drugs group （P〈0. 01, 0. 05, 0. 05, 0. 01, 0.01）. CFR of SAP patients treated by therapeutic endoscopy combined with the traditional Chinese medicine was not markedly different from the group of traditional Chinese medicine combined with west drugs （P〉0. 05）. [Conclusion]The therapeutic effect of endoscopy therapy combined with the traditional Chinese medicine is associated with eliminating obstruction of common bile duct and rapidly falling the level of cytokines and LPS in serum.