急性胰腺炎肠屏障功能改变及理气通下合剂保护作用观察

Observation on protective effects of Liqi Tongxia Decoction on intestinal barrier changes in patients with acute pancreatitis

目的:观察理气通下合剂对急性胰腺炎患者肠屏障功能障碍的影响。方法:用随机数字表法将40例患者随机分为理气通下组(A组)和硫酸镁组(B组)。记录入院0h、24h、48h、72h及第5d的胃肠功能评分和排便次数,测定入院0h、72h和第5天的尿乳果糖/甘露醇(L/M)比值、血浆内毒素水平、血清TNF-α和IL-6水平。结果:两组重症急性胰腺炎例数差异无统计学意义(P>0.05)。治疗第5d,两组排便次数较入院时增加;两组胃肠功能评分以及A组L/M比值、内毒素、TNF-α和IL-6较入院时均有所降低,B组上述指标较入院时有所升高。A组胃肠功能评分、排便次数、L/M比值、内毒素、TNF-α和IL-6改善较B组明显,差异有统计学意义(P<0.05)。结论:理气通下合剂能明显降低急性胰腺炎患者的肠道通透性,保护肠屏障功能。

Objective：To observe the influence of Liqi Tongxia Decoction on intestinal barrier dysfunction in patients with acute pancreatitis.Methods：40 subjects were randomly divided into Liqi Tongxia Decoction group（A）and Magnesium sulfate group（B）,20 cases in each group.To record the gastrointestinal functions score（GFS）and the frequency of defecation（FD） at 0hr,24hr,48hr,72 hr and on the 5th day after admission.To assay the ratio of Lactulose/Mannitol（L/M）,plasma Endotoxin,serum TNF-αand IL-6 at 0hr,72hr and on the 5th day.Results：The ratio of severe acute pancreatitis was not significantly different（P0.05）between the two groups.On the 5th day after admission,the FD in the two groups were elevated.The GFS in the two groups,and the L/M,DAO,Endotoxin,TNF-αand IL-6 in group A were decreased.The L/M,DAO,Endotoxin,TNF-α and IL-6 in group B were elevated.The ratio of severe acute pancreatitis was not significantly different（P0.05）between the two groups.The GFS,FD,L/M,DAO,Endotoxin,TNF-αand IL-6 were significantly different（P0.05）between the two groups on the 5th day after admission.Conclusion：The Liqi Tongxia Decoction can alleviate the gut permeability and protect the intestinal barrier in patients with acute pancreatitis.