赤芍大黄煎剂早期辅助治疗对重症急性胰腺炎患者腹腔内压力、血清肿瘤坏死因子α及白细胞介素6水平的影响

Effect of Radix Paeoniae Rubra and Rhubarb Decoction in Early Adjuvant Treatment of Severe Acute Pancreatitis on Patients' Intra-Abdominal Pressure,Serum TNF-α and IL-6

目的:探讨赤芍大黄煎剂早期辅助治疗对重症急性胰腺炎患者腹腔内压力(IAP)、血清肿瘤坏死因子α(TNF-α)及白细胞介素6(IL-6)水平的影响。方法:选取2015年10月—2016年10月潜江市中心医院收治的重症急性胰腺炎患者90例,以随机数字表法分为观察组和对照组,每组45例。对照组患者给予常规药物治疗,观察组患者在对照组的基础上加用赤芍大黄煎剂治疗。比较两组患者临床症状消失时间及抗菌药物使用时间,治疗前后IAP、血清TNF-α和IL-6水平的差异。结果:观察组患者的腹痛、发热、恶心呕吐及腹部压痛消失时间和抗菌药物使用时间明显短于对照组,差异均有统计学意义(P<0.05);治疗后,观察组患者平均IAP水平为(8.12±2.02)mm Hg(1 mm Hg=0.133 k Pa),明显低于对照组的(10.32±3.01)mm Hg,差异有统计学意义(P<0.05);治疗后,两组患者血清TNF-α、IL-6水平均明显低于治疗前,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05)。结论:赤芍大黄煎剂早期辅助治疗重症急性胰腺炎,可有效降低患者血清TNF-α、IL-6水平,减轻IAP。

OBJECTIVE： To probe into the effect of radix paeoniae rubra and rhubarb decoction in early adjuvant treatment of severe acute pancreatitis on patients ＇intra-abdominal pressure（ IAP）,serum tumor necrosis factor-α（ TNF-α） and interleukin-6（ IL-6）. METHODS： 90 patients with severe acute pancreatitis admitted into Qianjiang Central Hospital from Oct. 2015 to Oct. 2016 were selected and divided into observation group and control group via random number table,with 45 cases in each. The control group was given conventional therapy,while the observation group was treated with radix paeoniae rubra and rhubarb decoction based on the control group. The disappearance time of clinical symptoms and antibiotics usage time of two groups were observed. Differences in the IAP,levels of serum TNF-α and IL-6 between two groups were compared. RESULTS： The disappearance times of abdominal pain,fever,nausea and vomiting,abdominal tenderness,the antibiotics usage time of observation group were significantly shorter than those of control group,with statistically significant differences（ P〈0. 05）; after treatment,the average IAP level of observation group [（ 8. 12 ± 2. 02） mm Hg,1 mm Hg = 0. 133 k Pa] was significantly lower than that of the control group [（ 10. 32 ± 3. 01） mm Hg],with statistically significant difference（ P〈0. 05）; after treatment,levels of serum TNF-α and IL-6 of both groups were significantly lower than those of before treatment,and those of observation group were significantly lower than the control group,with statistically significant differences（ P〈0. 05）. CONCLUSIONS：Radix paeoniae rubra and rhubarb decoction in early adjuvant treatment of severe acute pancreatitis can significantly reduce patients serum TNF-α and IL-6 levels,and relieve intra-abdominal pressure.