大黄逐瘀汤内服与灌肠治疗重症急性胰腺炎瘀毒互结证的临床疗效及对血清炎症因子的影响

Clinical Efficacy of Dahuang Zhuyu Decoction for Oral Administration and Enema on Severe Acute Pancreatitis with Syndromes of Blood Stasis,Toxin and Its Effect on Serum Inflammatory Factors

目的:观察大黄逐瘀汤内服与灌肠治疗重症急性胰腺炎瘀毒互结证的临床疗效及对血清炎症因子的影响。方法:将2017年9月至2018年12月河南省人民医院收治的重症急性胰腺炎瘀毒互结证患者68例,采用随机数字表法分为治疗组和对照组,各34例,对照组采用西医常规治疗,治疗组在对照组的基础上采用大黄逐瘀汤内服与灌肠治疗。两组均治疗7 d。治疗前后分别进行腹痛、腹胀、恶心呕吐症状评分;进行血清淀粉酶(amylase,AMS),脂肪酶(lipase,LPS),白细胞介素-6(interleukin 6,IL-6),白细胞介素-10(interleukin-10,IL-10),肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平检测;记录腹痛消失时间、腹胀消失时间及排气恢复时间。结果:治疗后,两组腹痛评分,腹胀评分,恶心呕吐评分,血清AMS,LPS,IL-6及TNF-α水平较本组治疗前均降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后,两组IL-10较本组治疗前均升高(P<0.05),且治疗组高于对照组(P<0.05)。治疗组腹痛消失时间、腹胀消失时间、排气恢复时间均短于对照组(P<0.05)。治疗组总有效率高于对照组(P<0.05)。结论:大黄逐瘀汤内服与灌肠治疗重症急性胰腺炎瘀毒互结证,能够减轻临床症状,降低淀粉酶及脂肪酶水平,抑制促炎因子表达,促进抗炎因子表达及肠道功能恢复,提高临床疗效。

Objective: To observe the clinical efficacy of Dahuang Zhuyu decoction for oral administration and enema on severe acute pancreatitis with syndromes of blood stasis and toxin and its effect on serum inflammatory factors.Method: Sixty eight patients with severe acute pancreatitis with syndromes of blood stasis and toxin who were admitted in Henan Provincial People’s Hospital from September 2017 to December 2018 were randomly divided into treatment group(34 cases) and control group(34 cases).The control group was treated with western medicine.The treatment group was treated with Dahuang Zhuyu decoction for oral administattion and enema in addition to the therapy of the control group.Both groups were treated for 7 days.Before and after treatment,abdominal pain,bloating,nausea and vomiting were scored separately,serum amylase(AMS),lipase(LPS),interleukin-6(IL-6),interleukin-10(IL-10) and tumor necrosis factor-α(TNF-α) were detected,and abdominal pain disappearance time,bloating disappearance time and exhaust recovery time were recorded.Result: After treatment,the abdominal pain score,abdominal distension score,nausea and vomiting score,serum AMS,LPS,IL-6 and TNF-α were lower than those before treatment(P<0.05),and those in treatment group was lower than those in control group(P<0.05).After treatment,IL-10 level in both groups was higher than those before treatment(P<0.05),and that in treatment group was higher than that in control group(P<0.05).The disappearance time of abdominal pain,the disappearance time of abdominal distension and the recovery time of exhaust were shorter in treatment group than in control group(P<0.05).The total effective rate of the treatment group was higher than that of the control group(P<0.05).Conclusion: Dahuang Zhuyu decoction for oral administration and enema for severe acute pancreatitis with syndromes of blood stasis and toxin can alleviate clinical symptoms,reduce amylase and lipase levels,inhibit the expression of pro-inflammatory factors,promote the expression of anti-inflammatory factors,restore intestinal function,and improve clinical efficacy.