桃核承气汤辅助西药综合保守治疗对重症胰腺炎炎症因子水平及肝肾功能的影响

Influence of Taohe Chengqi Decoction Combined with Western Medicine Conservative Treatment on Levels of Inflammatory Factors and Liver and Kidney Function in Patients with Severe Pancreatitis

目的:观察桃核承气汤联合西药综合保守治疗对重症胰腺炎患者炎症因子水平及肝肾脏器的影响。方法:以我院收治的460例重症胰腺炎患者为对象,盲法随机分为单一组、联合组各230例,单一组实施常规西药治疗,联合组加用桃核承气汤口服,评估治疗后两组临床疗效,检测治疗前后两组白介素-6 (IL-6)、白细胞介素-8 (IL-8)、肿瘤坏死因子-α(TNF-α)、丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)、血肌酐(SCr)、血尿素氮(BUN)以评估炎症因子水平和肝肾功能,比较两组预后效果及药物安全性。结果:联合组有效率为86. 96%,高于单一组的78. 26%,组间比较有统计学意义(P<0. 05);与治疗前及治疗后单一组相较,治疗后联合组IL-6、IL-8、TNF-α和ALT、AST、SCr、BUN、APACHEⅡ评分降低明显(P <0. 05);联合组并发症率为5. 22%显著低于单一组的12. 17%(P<0. 05)。结论:桃核承气汤辅助西药综合保守治疗重症胰腺炎患者,临床疗效显著,在明显降低患者炎症因子水平的同时保护患者肝肾功能,有效降低并发症发生率且预后效果佳。

Objective： To investigate the effect of Taohe Chengqi Decoction combined with western medicine conservative treatment on levels of inflammatory factors and liver and kidney function in patients with severe pancreatitis. Methods：460 patients with severe pancreatitis in our hospital were selected as the subjects and they were randomly divided into single group and combined group with 230 cases in each group by blind method. The single group was treated with routine western medicine while the combined group was additionally treated with Taohe Chengqi Decoction. The clinical curative effect was evaluated after treatment. Levels of interleukin-6（ IL-6）,interleukin-8（ IL-8）,tumor necrosis factor α（ TNF-α）,alanine aminotransferase（ ALT）,aspartate aminotransferase（ AST）,serum creatinine（ SCr） and blood urea nitrogen（ BUN） were detected before and after treatment to evaluate levels of inflammatory factors and liver and kidney function. The prognosis and drug safety were compared between the two groups. Results： The effective rate of the combined group was higher than that of the single group（ 86. 96% vs78. 26%）（ P〈0. 05）. Levels of IL-6,IL-8,TNF-α,ALT,AST,SCr and BUN and APACHE II score in the combined group after treatment were significantly lower than those before treatment and those in the single group after treatment（ P〈0. 05）. The incidence of complications in the combined group was lower than that in the single group（ 5. 22% vs12. 17%）（ P〈0. 05）. Conclusion： Taohe Chengqi Decoction combined with western medicine conservative treatment is effective in the treatment of severe pancreatitis. The regimen can reduce the levels of inflammatory factorsand protect the liver and kidney function at the same time. It can effectively reduce the incidence of complications and the prognosis is good.