大黄承气汤联合保留灌肠对重症急性胰腺炎肠道菌群及免疫功能的影响

Effect of Dahuang Chengqi decoction combined with retention enema on intestinal flora and immune function in severe acute pancreatitis

目的:探讨大黄承气汤联合保留灌肠对重症急性胰腺炎的肠道菌群及免疫功能的影响。方法:选择重症急性胰腺炎患者100例,按照入组先后顺序分为观察组和对照组各50例。对照组予以常规处理措施,观察组联合大黄承气汤保留灌肠治疗,均持续治疗10 d。比较治疗后临床疗效、胃肠功能恢复时间、住院时间、肠道菌群数量、免疫功能、不良反应及死亡率。结果:观察组临床疗效总有效率为92.00%,明显比对照组的74.00%更高(P<0.05);观察组腹痛及腹胀消失时间、肠鸣音恢复时间、肛门排气时间、住院时间均明显比对照组短(P<0.05);治疗后,两组肠球菌、大肠埃希菌数量较治疗前均降低,乳酸杆菌、双歧杆菌数量均升高(P<0.05),观察组改善程度明显优于对照组(P<0.05);治疗后,两组CD 3+、CD 8+、CD 4+/CD 8+较治疗前均升高(P<0.05),且观察组上述指标均明显高于对照组(P<0.05);治疗期间两组均无明显相关药物不良反应,与对照组的死亡率20.00%相比,观察组6.00%明显更低(P<0.05)。结论:大黄承气汤联合保留灌肠在重症急性胰腺炎患者中的治疗效果明显,可帮助患者调节肠道菌群,促进免疫功能改善,降低病死率。

Objective:To study the effect of Dahuang Chengqi decoction combined with retention enema on intestinal flora and immune function in severe acute pancreatitis.Methods:100 patients of severe acute pancreatitis were divided into observation group and control group by the order of enrollment,with 50 cases in each group.The control group was treated with routine treatment,the observation group was combined with Dahuang Chengqi decoction and retention enema,they were treated for 10 days.After treatment 10 days,gastrointestinal function recovery time,hospitalization time,number of intestinal flora,immune function,adverse reactions and mortality were compared between the two groups.Results:The total effective rate results in the observation group was 92.00%,which was significantly higher than the control group 74.00%(P<0.05);the abdominal pain and distention disappearance time,bowel sounds recovery time,anal exhaust time and hospitalization in the observation group were significantly shorter than the control group(P<0.05);after treatment,the number of Enterococcus and Escherichia coli in the two groups were decreased,and the number of Lactobacillus and Bifidobacterium were increased(P<0.05);the improvement in the observation group were better than the control group(P<0.05);after treatment,the CD 3+,CD 8+and CD 4+/CD 8+in the two groups were higher than before treatment(P<0.05);the above indexes in the observation group were significantly higher than the control group(P<0.05);during the treatment,there was no significant adverse drug reaction in both groups,in the mortality,compared with 20.00%of the control group,the observation group was 6.00%,significantly lower(P<0.05).Conclusion:D ahuang Chengqi decoction combined with retention is well for severe acute pancreatitis,which can help patients adjust intestinal flora,improve the immune function,reduce the mortality.