雪莲注射液对重症急性胰腺炎患者的治疗作用

The therapeutic effect of Saussurea involucrata injection on severe acute pancreatitis

目的探讨雪莲注射液对重症急性胰腺炎(SAP)的治疗作用。方法将50例SAP患者采用随机数字表法分为常规治疗组(给予常规治疗)和雪莲注射液组(给予常规治疗+0.5%雪莲注射液肌内注射),各25例;另择健康体检者25例为正常对照组(不给予任何治疗)。治疗前及治疗后10 d,采用双抗体夹心酶联免疫吸附试验(ELISA)检测血清Beclin-1、微管相关蛋白1轻链3(LC3)水平,ELISA法检测血清核因子(NF)-κB p65、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β及IL-10水平。评估常规治疗组和雪莲注射液组患者急性生理与慢性健康评分(APACHE)Ⅱ及胰腺改良CT严重指数评分(MCTSI),并记录其住院时间和腹痛缓解时间。结果治疗前,常规治疗组和雪莲注射液组血清Beclin-1、LC3、NF-κB p65、TNF-α、IL-1β和IL-10水平均明显高于正常对照组(P<0.05)。治疗后10 d常规治疗组和雪莲注射液组血清Beclin-1、LC3、NF-κB p65、TNF-α和IL-1β水平较治疗前降低,且雪莲注射液组低于常规治疗组;IL-10水平较治疗前升高,且雪莲注射液组高于常规治疗组(P<0.05)。常规治疗组和雪莲注射液组APACHEⅡ、胰腺MCTSI评分较治疗前降低,且雪莲注射液组低于常规治疗组(P<0.05)。雪莲注射液组住院时间和腹痛缓解时间均低于常规治疗组(P<0.05)。结论雪莲注射液对SAP患者有较好的辅助治疗作用,其作用机制与抑制胰腺腺泡细胞异常自噬及阻断炎症反应NF-κB信号通路有关。

Objective To explore the therapeutic effect of Saussurea involucrata injection on severe acute pancreatitis(SAP).Methods Fifty SAP patients were randomly divided into the routine treatment group(treated with routine method)and the Saussurea involucrata injection group(treated with routine method plus i.m.0.5%Saussurea involucrata injection)by using random number table method,25 patients in each group.At the same time,25 healthy physical examinees were used as normal control group(treated with nothing).At 1 d before treatment and 10 d after treatment,the serum levels of Beclin-1 and microtubule-associated protein-1 light chain-3(LC3)were measured by double antibodies sandwich enzyme-linked immunosorbent assay(ELISA),and the serum levels of nuclear factor kappa B(NF-κB)p65,tumor necrosis factor(TNF)-α,interleukin(IL)-1βand IL-10 were measured by ELISA.The acute physiology and chronic health evaluation(APACHE)Ⅱand pancreas modified CT severity index(MCTSI)scores were evaluated,and patient hospital stay and abdominal pain relief days were also recorded in routine treatment group and Saussurea involucrata injection group.Results Before treatment,the serum levels of Beclin-1,LC3,NF-κB p65,TNF-α,IL-1βand IL-10 were significantly higher in routine treatment group and Saussurea involucrata injection group than those in normal control group(P<0.05).After 10-day treatment,the serum levels of Beclin-1,LC3,NF-κB p65,TNF-αand IL-1βwere decreased in routine treatment group and Saussurea involucrata injection group,and which were lower in Saussurea involucrata injection group than those of routine treatment group.The serum levels of IL-10 increased after treatment in both groups on 10-day after treatment,and which was significantly higher in Saussurea involucrata injection group than that in routine treatment group(P<0.05).The scores of APACHEⅡand pancreas MCTSI decreased in routine treatment group and Saussurea involucrata injection group,and which was significantly lower in Saussurea involucrata injection group than that in routine treatment group(P<0.05).The hospital stay and relief days of abdominal pain were significantly lower in Saussurea involucrata injection group than those in routine treatment group(P<0.05).Conclusion Saussurea involucrata injection has an auxiliary therapeutic role in SAP patients,and its mechanism may be through inhibiting abnormal autophagy activation of pancreatic acinar cells and blocking inflammatory response NF-κB signaling pathway in SAP.