丹参对重症急性胰腺炎微循环紊乱干预的临床研究

Clinical Research about Effects of Salvia Miltiorrhiza on Microcirculation in Patients with Severe Acute Pancreatitis

目的观察丹参对重症急性胰腺炎(SAP)内皮功能的影响,探讨丹参对改善重症急性胰腺炎患者微循环的作用。方法收集57例SAP患者随机分为对照组和丹参组,对比两组血浆TXA2和PGI2水平、临床指数、生化指标、A-PACHEⅡ评分及临床预后。结果入院时两组TXA2,TXA2/PGI2比值无明显差别,入院后3,7,14d丹参组较对照组显著降低(P<0.05或P<0.01);腹痛缓解时间,体温,白细胞计数恢复时间及血淀粉酶恢复正常时间丹参组显著短于对照组(P<0.01);丹参组入院后3,7,14dAPACHEⅡ评分显著低于对照组(P<0.05或P<0.01);并发症发生率丹参组明显低于对照组(P<0.01),而中转手术率、病死率两组无显著性差异(P>0.05)。结论丹参对于SAP的治疗有显著的临床疗效,丹参可能通过纠正TXA2/PGI2之间的平衡而改善胰腺微循环,这可能是其治疗SAP的作用机理之一。

Objective To explore the effects of salvia miltiorrhiza on vascular endothelial function and microcirculations in patients with server acute pancreatitis（SAP）.Methods 57 patients with SAP were randomly divided into control group and experiment group.Patients in control group received routine treatment,and the patients in experiment group received additional salvia miltiorrhiza.The changes of plasma TXA2,PGI2,clinical and laboratory parameters,APACHEⅡ score and clinical efficacy were monitored and compared.Results Plasma TXA2,the ratio of TXA2/PGI2 were significantly lower in the experiment group as compared with the control group on the 3,7,14 d after treatment（P〈0.05 or P〈0.01）.The time of abdominal pain duration,recover time of body temperature and leukocyte count,and restoration of normal serum amylase level in the experiment group were signification shorter than those in the control group（P〈0.01）.The scores of APACHEⅡin experiment group were significantly lower than those in the control group on the 3,7,14 d after treatment（P〈0.05 or P〈0.01）.The rate of complications in the experiment group was significantly lower than that in the control group（P〈0.01）,while the operation rate and mortality in the two group had no significant difference（P〉0.05）.Conclusion The salvia miltiorrhiza shows a significant efficacy on SAP through correcting the imbalance between TXA2 and PGI2 to improve the microcirculation of pancreas.