乌司他汀联合清胰汤治疗急性胰腺炎疗效探讨

Use of Ulinastatia combined with Chinese Medicine Qing Yi Tang in the treatment of acute pancreatitis

目的观察乌司他汀联合清胰汤对急性胰腺炎（acute pancreatitis，AP）患者临床指标和IL-8、TNF—α等炎症因子水平的影响，探讨其临床价值。方法259例患者分为观察组（141例）和对照组（118例），均行胃肠减压、补液、抗感染以及乌司他汀抑制胰腺分泌、减轻炎症反应等治疗，观察组加用清胰汤鼻饲，肠功能恢复后可行肠内营养。分别观察两组患者全身炎症反应、肠道功能恢复时间、禁食时间，并加以比较IL-8、IL-10、TNF—α、C反应蛋白（CRP）、血浆白蛋白、前白蛋白等指标。结果观察组腹胀消退需（6．35±2．75）d，禁食（8．42±2．45）d；对照组腹胀消退需（13．34±3．29）d，禁食（15．18±4．75）d，均P〈0．01。观察组IL-8、TNF—α、CRP水平治疗后下降趋势较对照组出现早，幅度明显；而IL-10上升趋势较对照组出现的早和明显。观察组白蛋白和前白蛋白恢复情况好于对照组。结论乌司他汀联合清胰汤能减轻急性胰腺炎患者局部和全身炎症反应，促进肠道功能恢复，改善患者营养状况。

Objective To examine the efficacy of Ulinastatia combined with Chinese medicine Qing Yi Tang in the treatment of acute pancreatitis （AP）. Methods A total of 259 patients with AP were randomly divided into 2 groups： A control group（ n = 118 ）and an experimental group （n = 141 ）. Routine treatment and ulinastia were given in both groups, and at the same time the Chinese medicine Qing Yi Tang were administered in the experimental group. The clinical outcomes were evaluated and the inflammatory mediators including interleukin - 8 （ IL - 8 ）, interleukin - 10 （ IL - 10）, tumor necrosis faetora （ TNF - α） , and C reactive protein（CRP） were measured in the patients of the two groups. Results The clinical outcomes in the experimental groups were significantly better than those in the control group, and the levels of IL-8 ,TNF- α and CRP in the serum in the experimental group were significantly lower than those in the control group（ P 〈 0.05 ）. But the level of IL - 10 in the serum in the experimental group was increased more quickly and significantly higher than that in the control group. The patients receiving Qing Yi Tang had significantly higher serum albumin and prealbumin level, shorter hospital stay than those in the control group （ P 〈 0.05 ）. Conclusion The Chinese Medicine Qing Yi Tang can ameliorate the pathological damage and inhibit the production of proinflammatory eytokines in the serum in patients with AP.