扶正逐瘀中药联合内镜介入治疗急性梗阻性化脓性胆管炎继发全身炎症反应的疗效分析

Analysis of the curarive effect of strengthening and removing blood stasis traditional Chinese medicine combined with endoscopic interventional treatment on acute obstructive suppurative cholangitis secondary systemic inflammation

[目的]观察扶正逐瘀中药联合内镜介入治疗急性梗阻性化脓性胆管炎(AOSC)继发全身炎症反应(SIRS)的疗效。[方法]随机选取AOSC继发SIRS的患者45例,随机分为清热解毒中药组(A组,在西医常规治疗基础上加服清热解毒中药)、扶正逐瘀中药组(B组,在A组的基础上加服扶正逐瘀中药)、及对照组(C组,仅应用西医常规治疗),每组15人,于治疗前、口服中药第3天、第7天检验血清白细胞计数(WBC)、降钙素原(PCT)、白介素6(IL-6)。[结果]A组、B组、C组中分别有1、1和2例被剔除,其余患者完成试验。口服中药第7天,检测41例患者白细胞计数:A组:(8.42±1.88)×109/L(与C组比较,差异无统计学意义);B组:(7.55±1.11)×109/L(与C组比较,差异有统计学意义);C组:(8.85±1.60)×109/L。降钙素原计数:A组:(0.83±0.39)ng/ml(与C组比较,差异无统计学意义);B组:(0.73±0.28)ng/ml(与C组比较,差异有统计学意义);C组:(1.08±0.39)ng/ml。白介素6:A组:(22.89±11.05)ng/L(与C组比较,差异无统计学意义);B组:(13.99±4.85)ng/L(与C组比较,差异有统计学意义);C组:(28.72±13.63)ng/L。[结论]清热解毒中药联合扶正逐瘀中药对AOSC继发SIRS的治疗有辅助治疗效果,可加快感染指标的恢复。

[Objective]To observe the efficacy of strengthening and removing blood stasis traditional Chinese medicine combined with endoscopic interventional treatment on acute obstructive suppurative cholangitis secondary systemic inflammation.[Methods]45cases diagnosed as AOSC secondary SIRS were randomly divided into three groups：clearing heat and detoxicating group.Each group has 15 cases.Detecting the serum white blood cell count,the content of PCT and IL-6before the treatment,3rd and 7th day of oraling traditional Chinese medicine.[Results]Group A,B,C had 1person,1person,2people eliminated respeetovely while others compelted the trial.On the 7th day of oral Chinese herbs,WBC：A group：（9.71±1.72）×10^9/L（complete with C group,P〉0.05）;B group：（7.35±1.40）×10^9/L（complete with C group,P〈0.05）;C group：（9.92±2.01）×10^9/L.PCT：A group：（1.29±0.94）ng/ml（complete with C group,P〉0.05）;B group：（0.80±0.41）ng/ml（complete with C group,P〈0.05）;C group：（1.66±0.76）ng/ml.IL-6：A group：（22.89±11.05）ng/L（complete with C group,P〉0.05）;B group：（13.99±4.85）ng/l（complete with C group,P〈0.05）;C group：（28.72±13.63）ng/l.[Conclusion]Clearing heat and detoxicating traditional Chinese medicine combined with strengthening and removing blood stasis traditional Chinese medicine have adjurant therapy effect on AOSC secondary SIRS and increase the infeetion index decline.