新加清胰汤内服联合中药灌肠治疗轻症急性胰腺炎的随机对照研究

A randomized controlled study on the treatment of mild acute pancreatitis by Newadd Qingyitang Decoction oral administration combined with traditional Chinese medicine enema

目的:探讨新加清胰汤内服联合中药灌肠治疗轻症急性胰腺炎的临床疗效。方法:选取2017年1月至2018年6月广西医科大学第一附属医院收治的轻症急性胰腺炎患者96例,按随机数字表达分为对照组(常规西医治疗)和试验组(常规西医治疗+新加清胰汤内服联合中药灌肠治疗),收集各病例临床症状(VAS疼痛评分、腹痛、腹胀缓解时间、排便恢复时间等)、实验室检查[白细胞(WBC)计数、C反应蛋白(CRP)、血淀粉酶、血脂肪酶、肝功能、电解质、血脂等]、影像学(B超或CT检查)表现、住院时间、治疗费用及不良反应发生率等资料,并在治疗前及治疗5 d后测定患者血清中血管生成素-2(Ang-2)、白介素-2(IL-2)、白介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平,观察两组治疗效果及各指标的差异。结果:与对照组相比,试验组腹痛、腹胀缓解时间及恢复排便时间较短(均P<0.05),在治疗2 d后试验组患者疼痛评分明显降低,治疗5 d后试验组WBC计数、CRP下降程度更大(均P<0.05);治疗后,Ang-2与IL-8明显下降,IL-2明显上升(均P<0.05),试验组总有效率优于对照组(P<0.05)。结论:新加清胰汤内服联合中药灌肠疗法可以控制炎症反应,在不增加患者痛苦及负担基础上,更快缓解症状并提高疗效,具有一定的临床推广价值。

Objective:To investigate the clinical effect of Newadd Qingyitang Decoction oral administration combined with traditional Chinese medicine enema on mild acute pancreatitis.Methods:A total of 96 patients with mild acute pancreatitis admitted to our hospital from January 2017 to June 2018 were selected and randomly divided into a control group(conventional western medicine treatment)and an experimental group(conventional Western medicine treatment+New add Qingyitang Decoction oral administration combined with traditional Chinese medicine enema).The clinical symptoms(VAS pain score,abdominal pain,abdominal distension relief time,defecation recovery time,etc.),laboratory tests including white blood cell count,C-reactive protein(CRP),blood amylase,lipase,liver function,blood electrolytes,blood lipid,etc.)and imaging(ultrasound or CT examination),hospital days,treatment cost,the incidence of adverse reactions after5 days treatment,the levels of angiogenin-2(Ang-2),interleukin(IL)-2,IL-8 and tumor necrosis factor(TNF)-α in serum were measured and compared.Results:Compared with the control group,abdominal pain,abdominal distension relief time and recovery time were shorter in the experimental group(P<0.05).After 2 days of treatment,the pain score in the experimental group decreased significantly,and WBC and CRP level decreased more significantly on day 5 post-treatment(P<0.05).After treatment,the Ang-2 and IL-8 levels were reduced while the IL-2 level was elevated in the experimental group compared with the control group(P<0.05).The total effective rate in the experimental group was higher than that in the control group(P<0.05).Conclusion:Newadd Qingyitang Decoction oral administration combined with traditional Chinese medicine enema can control the inflammatory response,relieve symptoms and improvecurative effect without increasing the pain and burden of patients,which is valuable for worth clinical popularization.