内镜与中药联合对治疗对急性化脓性胆管炎血清急性时相蛋白的影响

Influences of treatment with endoscopic combined with Chinese herbs for suppurative cholangitis on acute phase proteins

目的：观察经内镜胆管引流和联合应用中药治疗急性化脓性胆管炎（ＡＳＣ）的临床疗效及其对血清急性时相蛋白（ＡＰＰ）的影响。方法：将２６例ＡＳＣ患者随机分为内镜加中药组（Ａ组，１４例）和手术引流组（Ｂ组，１２例）。并监测治疗前后６种ＡＰＰ的变化。结果：２组患者入院时Ｃ反应蛋白（ＣＲＰ）、铜蓝蛋白（ＣＰ）、α１抗胰蛋白酶（α１ＡＴ）、α１酸性糖蛋白（α１ＡＧ）与正常参考值均出现显著增高，纤维连接蛋白（Ｆｎ）明显降低。Ａ组在治疗后第４日伴随Ｆｎ的上升，ＣＲＰ、ＣＰ、α１ＡＴ、α１ＡＧ均明显下降〔Ｆｎ：（０．２５±０．０４）ｇ／Ｌｖｓ．（０．１６±０．０８）ｇ／Ｌ；ＣＲＰ：（３０．１４±１６．７１）ｍｇ／Ｌｖｓ．（７６．４５±２６．３３）ｍｇ／Ｌ；ＣＰ：（０．６４±０．１５）ｇ／Ｌｖｓ．（０．９０±０．２１）ｇ／Ｌ；α１ＡＴ：（５．２９±０．９６）ｇ／Ｌｖｓ．（６．６３±１．５６）ｇ／Ｌ；α１ＡＧ：（０．９６±０．４４）ｇ／Ｌｖｓ．（１．７０±０．６１）ｇ／Ｌ，Ｐ＜０．０５或Ｐ＜０．０１〕。在治疗后第７日ＡＰＰ各项指标基本恢复至正常水平，且与Ｂ组比较有显著性差异（Ｐ＜０．０５或Ｐ＜０．０１）。结论：内镜与中药联合治疗Ａ?

Objective :To observe the clinically curative effects of endoscopic biliary drainage combined with Chinese herbs on acute suppurative cholangitis (ASC) and the influence on acute phase proteins (APP). Methods :26 cases with ASC were randomly divided into A group (endoscopic plus Chinese herbs,n=14) and B group (operative drainage,n=12).Six types of APP before and after therapy were monitored. Results :At the time of admittion all the concentrations of C reaction protein (CRP),ceruloplasmin (CP),1 antitrypsin (1 AT),and 1 acid glycoprotein (1 AG) were significantly increased but fibronectin (Fn) significantly decreased in both A and B groups.After 4 days therapy,however in A group following the elevation of Fn all the concentrations of CRP,CP,1 AT,and 1 AG were significantly depressed in A group Fn:(025004)g/L vs.(016008)g/L;CRP:(30141671)mg/L vs.(76452633)mg/L;CP:(064015)g/L vs.(090021)g/L;1 AT:(529096)g/L vs.(663156)g/L:1 AG:(096044)g/L vs.(170061)g/L;P<005 or P<001.After 7 days therapy all the parameters of APP basically returned to normal levels in A group and the differences compared with B group were significant (P<005 or P<001). Conclusions :The curative effects of endoscopic combined with Chinese herbs on ASC are obvious and Chinese herb can promote the recovery of immune damage.