银杏叶提取物治疗重症急性胰腺炎的疗效分析

Clinical study on severe acute pancreatitis treated with ginkgo biloba extract

目的探索银杏叶提取物治疗重症急性胰腺炎（SAP）的机制和效果。方法采用前瞻性病例对照研究。安阳市人民医院2006年12月至2010年10月收治的符合人选标准的重症急性胰腺炎患者54例，随机分为两组，两组资料具有可比性。银杏叶提取物＋综合治疗组（治疗组）25例，完成实验过程21例。单纯综合治疗组（对照组）29例，完成实验过程23例。综合治疗包括应用生长抑素、抗生素等，治疗组在此基础上每日静滴银杏叶提取物87．5mg。于治疗前，治疗后第3天、7天，检测两组血TNF-α、IL-6、淀粉酶水平；检测治疗前和治疗后第7天血清MDA水平，BalthazarCT评分；观察两组腹痛、腹胀、压痛变化；比较胰腺感染发生率。所有实验数据应用SPSS11．0统计软件处理，计量资料使用重复测量资料方差分析和成组t检验行统计分析；计数资料以x。检验行统计分析。结果治疗组第3天、7天血TNF-α、IL-6、血淀粉酶水平均低于对照组（P〈0．05，P〈0．01）；第7天血清MDA水平，BalthazarCT评分低于对照组（P〈0．05）；治疗组腹痛、腹胀、压痛消失的时间短于对照组（P〈0．01）；治疗组胰腺感染发生率低于对照组（P〈0．05）。结论银杏叶提取物能明显减轻SAP患者的细胞因子释放，抑制氧化应激，清除体内氧自由基，迅速缓解患者临床症状，防治胰腺感染和坏死，抑制病情发展。

Objective To investigate the therapeutic effect and function mechanism of ginkgo biloba extract （EGb） for severe acute pancreatitis. Methods Fifty - four patients, who were diagnozed according to the inclusion criteria, were divided into two groups at random. They were from the People＇s Hospital of Anyang City from November 2006 to December 2010. In treatment group, 25 patients were treated with integrated EGb and other comprehensive treatment group , and 21 patients completed the treatment; in the the contrast group, the 29 patients were trested with simple comprehensive treatment group, and 23 patients completed the treatment. Comprehensive therapy included Somatostatin and antibiotic, ect. Besides the comprehensive therapy, patients in the treatment group were intra - venously infused with 87. 5 mg EGb everyday. Before the day of treatment, on the 3rd and 7th day after the treatment, blood TNF-a, IL-6 and amylase level were determined. Blood MDA level was measured and Bahhazar CT grades was observed before the day of treatment and on the 7th day after the treatment. Abdominal pain, abdominal distension and tenderness were observed. Pancreatic infection incidence rate was compared between the two groups. All experimental data were processed with SPSS version 11. 0 statistical software. Quantitative data were analyzed byRepeated Measurement ANOVA or t -test. Count data were analyzed by x2 test. Results The values of blood TNF-α, IL-6 and amylase level were significantly lower in treatment group than in contrastgroup on the 3rd and 7th day after the treatment （P 〈 0. 05 ）. The values of blood MDA and Balthazar CT grades were significantly lower in treatment group than in the contrast group on the 7th day after the treatment （ P 〈 0. 05 ）. There was a significantly shorter period of abdominal pain, abdominal distension and tenderness in treatment group than in contrast group. （P 〈0. 01 ）. The pancreatic infection incidence rate of the treatment group was lower than that of the contrast group （P 〈 0. 05）. Conclusions EGb could alleviate notably the cytokine retease, restrain oxidative stress and remove the free oxygen factor, prevent and treat Pancreatic infection and necrosis.