生长抑素与清胰汤联合治疗急性重症胰腺炎的疗效观察

Somatostatin combined with Qingyi Decoction treats severe acute pancreatitis

目的评价生长抑素与清胰汤(柴胡,黄芩,胡黄连等)在联合治疗急性重症胰腺炎中的作用。方法将62名重症胰腺炎患者随机分为3组:常规治疗组、生长抑素组、生长抑素+清胰汤组。在治疗的第4、7天,监测患者腹痛/腹胀缓解时间,血淀粉酶、TNF-α、IL-6的水平,胃肠减压量,平均住院天数,并发症的发生率及死亡率。结果在治疗第4、7天,生长抑素+清胰汤组的胃肠减压量较生长抑素组下降明显;生长抑素+清胰汤组的腹痛缓解时间、平均住院天数较生长抑素组下降明显;在治疗第4天,生长抑素+清胰汤组的血淀粉酶和TNF-α水平较生长抑素组下降明显。结论生长抑素与清胰汤联合应用可进一步改善急性重症胰腺炎患者的预后,其可能的作用机制是进一步减轻急性期炎症介质TNF-α的过度释放。

AIM To evaluate the efficacy of somatostatin combined with Qingyi Decoction（ Bupleuri Radix,Scutellariae Radix,Picrorhizae Rhizoma,etc.） in the treatment of severe acute pancreatitis. METHODS Sixtytwo patients with severe acute pancreatitis were randomly divided into three groups： basic treatment,somatostatin,and somatostatin ＋ Qingyi Decoction group. Several indices were analyzed and compared among all the three groups,including the improvement rate of abdominal pain and distention,the levels of serum amylase,tumor necrosis factor-α（ TNF-α） and interleukin（ IL）-6,the volume of stomach decompression,hospitalization days,the incidence of complication and in-hospital mortality. RESULTS The volume of stomach decompression on the fourth and the seventh days after the treatment decreased significantly in the somatostatin ＋ Qingyi Decoction group compared with the somatostatin group. The improvement rate of abdominal pain and distention,and hospitalization days,were lower in the somatostatin ＋ Qingyi Decoction group compared with the somatostatin group. So were the serum amylase and TNF-α level on the fourth day. CONCLUSION Somatostatin combined with Qingyi Decoction can significantly improve the prognosis of patients with severe acute pancreatitis. The mechanism of this combination maybe reduce release of acute phase inflammatory mediator TNF-α.