清胰汤加减辅助治疗重症胰腺炎及对血淀粉酶、肿瘤坏死因子-α、白细胞介素-6的水平影响

Effect of Qingyi Decoction on Serum Levels of Ams, TNF- α and IL-6 of Patients with Severe Pancreatitis

目的分析清胰汤加减辅助治疗重症胰腺炎对患者血淀粉酶(Ams)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的水平影响。方法选取2016年11月-2018年10月收治的重症胰腺炎患者104例,根据治疗方法不同分为对照组(常规西医治疗)和观察组(清胰汤加减辅助常规西医治疗),分析两组患者治疗后的临床疗效。结果两组治疗前中医症状积分组间比较,差异不具有统计学意义(P>0.05)。观察组治疗后腹痛、痞满燥实坚、恶心呕吐、日晡潮热、口干口渴、小便短赤积分低于对照组(P<0.05)。观察组患者腹痛缓解时间(4.82±2.12)d、恢复肠鸣音时间(4.43±1.96)d、首次排便时间(4.30±2.28)d短于对照组(P<0.05)。两组治疗前炎症因子、胃肠激素、Ams、髓样细胞触发受体-1(TREM-1)、血清微管相关蛋白1轻链3(MAP1-LC3)水平组间比较,差异不具有统计学意义(P>0.05)。观察组治疗后Ams、TNF-α、IL-6、TREM-1、MAP1-LC3、血清胃肠激素活动性肠肽(VIP)、肠抑胃肽(GIP)水平低于对照组(P<0.05)。结论清胰汤加减辅助治疗重症胰腺炎可抑制炎症反应,降低胃肠激素、TREM-1、MAP1-LC3的表达水平,促进肠鸣音的恢复,缓解临床症状。

Objective To analyze the effect of Qingyi Decoction on the serum levels of amylase(Ams), tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in patients with severe pancreatitis. Methods A total of 104 patients with severe pancreatitis admitted in our hospital(November 2016 to October 2018) were divided into control group(conventional western medicine treatment) and observation group(Qingyi Decoction auxiliary routine western medicine treatment) according to different treatment methods. We analyzed the clinical effect of two groups after treatment. Results There was no significant difference between the two groups before treatment(P>0.05). In the observation group, the scores of abdominal pain, full dryness, nausea and vomiting, respiratory fever, dry mouth thirst and short urinary deficit were lower than those in the control group(P<0.05). The abdominalgia relief time was(4.82±2.12) days, the recovery time was(4.43±1.96) days, the first defecation time was(4.30±2.28) days,which were shorter than those in the control group(P<0.05). There was no statistically significant difference between the two groups in the levels of pre-treatment inflammatory cytokines, gastrointestinal hormones, Ams, myeloid cell-triggered receptor-1(TREM-1) and serum microtubule-associated protein 1 light chain 3(MAP1-LC3)(P>0.05). After treatment, Ams, TNF-alpha, IL-6, TREM-1, MAP1-LC3, serum gastrointestinal hormone activity intestinal peptide(VIP) and intestinal inhibitory peptides(GIP) in the observation group were lower than those in the control group(P<0.05). Conclusion Qingyi Decoction can inhibit inflammatory reaction, decrease the expressions of gastrointestinal hormone,TREM-1 and MAP1-LC3,promote the recovery of bowel sound and relieve clinical symptoms.