通里攻下法对重症急性胰腺炎患者血清降钙素原和C反应蛋白水平的影响

The influence of the Tongli Gongxia therapy on serum procalcitonin and C-reactive protein levels in patients with severe acute pancreatitis

目的:观察大承气汤对重症急性胰腺炎患者血清降钙素原和C反应蛋白水平的影响。方法:选取2012年10月-2015年10月在我院住院治疗的重症急性胰腺炎患者92例为研究对象,随机分成对照组和联合组,各46例。对照组采用静脉泵入奥曲肽进行治疗,联合组采用奥曲肽联合大承气汤进行治疗。观察组两组患者症状缓解时间和指标恢复时间;分析治疗第1天、第4天、第7天两组患者白细胞、血清降钙素原和C反应蛋白水平。结果:①联合组患者治疗后腹痛、腹胀症状缓解时间分别为(4.0±0.6)天和(4.1±1.4)天,明显低于对照组的(5.9±1.6)天和(5.7±1.7)天,组间对比差异明显,P<0.05;②联合组患者治疗后血清淀粉酶、白细胞恢复时间及住院时间分别为(5.2±0.8)天、(6.5±1.3)天和(23.1±1.0)天,明显低于对照组的(6.9±1.6)天、(8.9±1.9)天和(31.5±2.4)天,组间对比差异具有统计学意义,P<0.05;⑤两组患者治疗第1天的白细胞计数、C反应蛋白、血清降钙素原的差异均不具有统计学意义,P>0.05;治疗4天,联合组白细胞计数为(12.2±1.6)×10~9/L、C反应蛋白为(52.06±8.45)mg/L、血清降钙素原为(1.33±0.53)μg/L,低于对照组的(15.0±0.9)×10~9/L、(73.49±12.34)mg/L和(1.52±0.26)μg/L,组间对比差异明显,具有统计学意义,P<0.05;治疗7天,联合组白细胞计数为(10.1±0.9)×10~9/L、C反应蛋白为(33.92±6.98)mg/L、血清降钙素原为(0.53±0.13)μg/L,低于对照组的(12.5±0.8)×10~9/L、(57.01±11.54)mg/L和(1.32±0.40)μg/L,组间对比差异明显,具有统计学意义,P<0.05。结论:大承气汤能有效改善重症急性胰腺炎患者的脘腹症状,减轻患者的炎性反应,阻断病情进展,提高临床疗效。

Objective:To observe the influence of the Dachengqi decoction on serum procalcitonin and C-reactive protein levelsin patients with severe acute pancreatitis.Methods:92cases were selected as research objects,and randomly divided into control groupand combined group,46cases in each group.The control group took intravenous pumping the peptide;the combined group receivedthe Dachengqi decoction more.Results:After treatment,remission time of abdominal pain and abdominal distension of patients in thecombined group were(4.0±0.6)and(4.1±1.4)days respectively,significantly lower than(5.9±1.6)and(5.7±1.7)days in the controlgroup,with obvious contrast difference between groups,P<0.05.After treatment,serum amylase,leukocyte recovery time and hospitalstay were(5.2±0.8),(6.5±1.3)and(23.1±1.0)days respectively,significantly lower than(6.91±.6),(8.9±1.9)and(31.5±2.4)days inthe control group,with statistical significance between groups,P<0.05.On the first day,white blood cell count,C-reactive protein,serumcalcitonin original in groups showed no statistically significant difference,P>0.05;In4days,those indexes in the combined group were(12.2±1.6)×109/L,(52.06±8.45)mg/L,(1.33±0.53)μg/L respectively,lower than(15.0±0.9)×109/L,(73.49±12.34)mg/L,(1.52±0.26)μg/L in the control group;there was obvious statistical differences between groups,P<0.05.In7days,those indexes in groups showedobviously statistical difference,P<0.05.Conclusion:The Dachengqi decoction could effectively improve the symptoms of severe acutepancreatitis patients,relieve inflammatory reaction,block progress,and improved clinical effects.