中西医结合治疗慢性胰腺炎脾胃湿热证临床观察

Clinical Observation of Applying Integrated Traditional Chinese and Western Medicine in Treating Chronic Pancreatitis with Spleen-stomach Damp-heat Syndrome

目的:观察中西医结合治疗慢性胰腺炎(CP)脾胃湿热证的临床疗效。方法:按随机数表法将2012年1月~2017年10月我科收治的76例CP脾胃湿热证患者分为中西医结合治疗组(研究组)和常规西医治疗组(对照组),各38例。比较治疗后两组患者临床疗效差异;记录治疗前(T1)和治疗1个月后(T2)两组患者胰腺内分泌功能[空腹血糖、空腹胰岛素、空腹C-肽]、胰腺外分泌功能[血清胆囊收缩素(CKK)、淀粉酶(AMY)、脂肪酶(LPS)、对氧磷酶-1(PON-1)]和中医症状积分(腹痛、腹胀、腹泻、恶心)的差异。结果:研究组治疗总有效率明显高于对照组(P<0.05)。T2时,两组患者部分胰腺内分泌指标(空腹血糖)、部分胰腺外分泌指标(CKK、AMY、LPS)水平均较T1时明显下降,且研究组下降更显著(P均<0.05);两组患者部分胰腺内分泌指标(空腹胰岛素、空腹C-肽)、PON-1水平均较T1时显著升高,且研究组明显高于对照组(P均<0.05)。T2时,两组患者中医症状积分均较T1时显著降低,且研究组明显低于对照组(P均<0.05)。结论:中西医结合治疗CP,能有效减轻炎症反应、防止胰腺纤维化进展,促进胰腺功能恢复,显著改善患者临床症状、提高治疗有效率。

Objective:To observe the clinical efficacy of integrated traditional Chinese and western medicine in treating chronic pancreatitis(CP) with spleen-stomach damp-heat syndrome.Methods:According to the random number table method, 76 cases of CP patients with spleen-stomach damp-heat syndrome treated in our department from January 2012 to October 2017 were divided into integrated traditional Chinese and western medicine group(study group) and conventional western medicine group(controlled group) with 38 cases in each group.The clinical efficacy was compared between the two groups after treatment, and the pancreatic endocrine function [fasting plasma glucose, fasting insulin, fasting C-peptide], pancreatic exocrine function [serum cholecystokinin(CKK), amylase(AMY), lipase(LPS), paraoxonase-1(PON-1)] and TCM symptoms scores(abdominal pain, abdominal distension, diarrhea, and nausea) were recorded before treatment(T1) and after 1 month of treatment(T2).Results:The total effective rate of treatment in the study group was significantly higher than that in the controlled group(P<0.05).At T2, the levels of pancreatic endocrine index(fasting blood glucose) and partial pancreatic exocrine indexes(CKK, AMY, LPS) in the two groups were significantly lower than those at T1, and the decline was more significant in the study group(all P<0.05).The levels of partial pancreatic endocrine indexes(fasting insulin, fasting C-peptide) and PON-1 were significantly higher than those at T1, and the levels in the study group were significantly higher than those in the controlled group(all P<0.05).At T2, the TCM symptoms scores in the two groups were significantly lower than those at T1, and the levels in the study group were significantly lower than those in the controlled group(P<0.05).Conclusions:Integrated traditional Chinese and western medicine for CP can effectively reduce the inflammatory response, prevent the progression of pancreatic fibrosis, promote the recovery of pancreatic function, and significantly improve the clinical symptoms and the effective rate of treatment.