大柴胡汤联合乌司他丁对肝郁气滞型轻症急性胰腺炎患者血清白细胞介素-1β和白细胞介素-6的影响

Effect of Dachaihu decoction combined with Ulinastatin on serum interleukin-1β and interleukin-6 in patients with severe acute pancreatitis with syndrome of liver qi stagnation

目的研究大柴胡汤联合乌司他丁治疗肝郁气滞型轻症急性胰腺炎的疗效及对血清白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)的影响。方法将53例肝郁气滞型轻症急性胰腺炎患者随机分为2组,均常规予以镇痛、解痉、抑酸及抑制胰腺分泌和抗感染等治疗,对照组26例在此基础上联合乌司他丁治疗,治疗组27例在对照组治疗基础上加用大柴胡汤治疗,检测2组治疗前及治疗3 d、5 d、7 d后血清IL-1β、IL-6水平,观察2组治疗前及治疗7 d后中医证候积分变化情况,统计2组临床疗效。结果 2组治疗3 d、5 d、7 d后血清IL-1β、IL-6水平均明显低于治疗前(P均<0.05),且治疗组治疗3 d、5 d后血清IL-1β、IL-6水平均明显低于对照组(P均<0.05)。2组治疗7 d后中医证候积分均明显低于治疗前(P均<0.05),且治疗组明显低于对照组(P均<0.05)。治疗组临床总有效率显著高于对照组(P<0.05)。结论大柴胡汤联合乌司他丁可有效下调肝郁气滞型轻症急性胰腺炎患者血清IL-1β和IL-6水平,减轻临床症状,提高综合疗效。

Objective It is to investigate the curative effect of Dachaihu decoction combined with Ulinastatin on liver qi stagnation type of mild acute pancreatitis and its effect on serum levels of interleukin-1β( IL-1β) and interleukin-6( IL-6). Methods Fifty-three patients with liver qi stagnation type of mild acute pancreatitis were randomly divided into two groups. The two groups were given routine therapy of analgesia,antispasmodic,acid suppression and inhibition of pancreatic secretion and anti-infection,additionally the control group( n = 26) was treated with Ulinastatin while the treatment group( n = 27) was treated with Dachaihu decoction plus Ulinastatin based on the routine treatment. The levels of IL-1βand IL-6 in the two groups before and after treatment for 3 d,5 d and 7 d were detected,the changes of TCM syndrome scores before treatment and after 7 days of treatment were observed in the two groups,and the clinical effects were compared between the two groups. Results Serum levels of IL-1β and IL-6 in the two groups were significantly lower after 3,5 and 7 days of treatment than those before treatment( P < 0. 05),and the levels of IL-1β and IL-6 were significantly lower in the treatment group than those in the control group( P < 0. 05). The scores of TCM syndromes in both groups after 7 days of treatment were significantly lower than those before treatment( P < 0. 05),and the scores in the treatment group were significantly lower than those in the control group( all P < 0. 05). The total effective rate of the treatment group was significantly higher than that of the control group( P < 0. 05). Conclusion Dachaihu decoction combined with Ulinastatin can effectively reduce the serum IL-1β and IL-6 levels,relieve clinical symptoms and improve the comprehensive effect in patients with liver qi stagnation type of mild acute pancreatitis.