大黄牡丹汤加减治疗急性胰腺炎对机体炎症和应激反应的影响

Effect on Inflammation and Stress Response of Acute Pancreatitis by Dahuang Mudan Decoction

目的:探讨大黄牡丹汤加减联合西药治疗急性胰腺炎的疗效,及其对机体炎症和应激反应的影响。方法:选择符合纳入标准的急性胰腺炎患者130例,根据随机数字表法分为观察组和对照组,每组65例。对照组予以常规西药治疗,观察组在对照组的基础上予以大黄牡丹汤加减治疗,观察两组患者治疗后的临床疗效;治疗前后血清淀粉酶,血清脂肪酶,尿淀粉酶,白介素(IL)-1,肿瘤坏死因子(TNF)-α,髓过氧化物酶(MPO),脂质过氧化物(LPO),超氧化物岐化酶(SOD)和过氧化氢酶(CAT)水平的变化。结果:观察组的总有效率为92.31%,对照组的总有效率为84.62%,两组疗效差异无统计学意义(χ2=1.206,P>0.05)。治疗前两组患者血清淀粉酶,血清脂肪酶,尿淀粉酶,IL-1,TNF-α,髓过氧化物酶,LPO,SOD和CAT水平差异无统计学意义(P>0.05),治疗后两组患者的血清淀粉酶,血清脂肪酶,尿淀粉酶,IL-1,TNF-α,MPO和LPO水平较治疗前明显降低(P<0.01),SOD和CAT水平较治疗前明显升高,但观察组的降低或者升高水平较对照组更为明显(P<0.01)。结论:大黄牡丹汤加减联合西药较单纯西药治疗急性胰腺炎,对机体的炎症反应和应激抑制更为明显,具有抗氧化损伤,清除机体自由基的作用。

Objective： To observe the efficacy of Dahuang Mudan decoction combined with western medicine in the treatment of acute pancreatitis and the effect on the inflammation and stress response. Methods： 130 patients with acute pancreatitis were divided into an observation group and a control group according to random number method, in each group with 65 cases. The control group received conventional western medicine, and the observation group received Dahuang Mudan decoction on the basis of the therapy in the control group. The efficacy after treatment, the levels of serum amylase and serum lipase, urine amylase, interleukin （IL） before and after treatment, tumor necrosis factor （TNF） - α, myeloperoxidase （ MPO ）, lipid peroxide （ LPO ）, changes in superoxide dismutase （SOD） and catalase （CAT） before and after treatment were observed in each group. Results： The total effective rate was 92. 31% in the observation group, and it was 84.62% in the control group. There was not a statistically significant difference between two groups （Х^2 = 1. 206, P 〉 0. 05 ）. Before treatment, the levels of serum amylase, lipase serum and urine amylase, IL - 1, TNF - α, myeloperoxidase, LPO, SOD and CAT had no significant difference between two groups （P 〉 0. 05）. After treatment, the levels of serum amylase, serum lipase and urine amylase, IL - 1, TNF -α, MPO and LPO were significantly decreased compared with those before treatment （P 〈 0. 01 ）, while the levels of SOD and CAT were significantly increased in two groups compared with those before treatment. The decreased or increased levels in the observation group were more significant compared with those in the control group （P 〈0. 01 ）. Conclusion： Dahuang Mudan decoction combined with western medicine in the treatment of acute pancreatitis and the effect on inflammation and stress response are more obvious than only western medicine, with the anti - oxidative damage and scavenging free radicals.