清胰汤联合中药外治法对重症急性胰腺炎患者胃肠功能指标、胰腺功能指标的影响

Effect of Qingyi Decoction Combined with External Treatment of Traditional Chinese Medicine on Gastrointestinal Function Index and Pancreas Function Index in Patients with Severe Acute Pancreatitis

目的观察清胰汤联合中药外治法对重症急性胰腺炎患者胃肠功能指标、胰腺功能指标的影响,评价其应用价值。方法60例重症急性胰腺炎患者采用随机数字表法将其分为治疗组与对照组各30例,对照组入院后予以常规治疗,治疗组在对照组基础上加用清胰汤联合中药外治法,两组均用药10 d。比较两组近期疗效、临床症状评分、肠道屏障功能指标(二胺氧化酶、D-乳酸、内毒素)、胰腺功能改善情况及炎症指标[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]。结果治疗组近期总有效率为80.00%,明显高于对照组的53.33%(P<0.05);治疗组治疗后各临床症状评分明显低于对照组(P<0.05);治疗组治疗后二胺氧化酶、D-乳酸、内毒素水平明显低于对照组(P<0.05);治疗组血淀粉酶恢复正常时间、尿淀粉酶恢复正常时间明显短于对照组(P<0.05);治疗组治疗后IL-6、IL-10、TNF-α水平明显优于对照组(P<0.05)。结论清胰汤联合中药外治法治疗重症急性胰腺炎疗效良好,能够改善患者临床症状和肠道屏障功能,降低全身炎症反应,促进胰腺功能康复。

Objective:To investigate the effect of Qingyi Decoction combined with traditional Chinese medicine on the gastrointestinal function index and pancreas function index in patients with severe acute pancreatitis(SAP),and to evaluate its application value.Methods:60 SAP patients were selected and divided into a treatment group(n=30)and a control group(n=30)by random number table method.On the basis of the control group,Qingyi Decoction was combined with external treatment of traditional Chinese medicine,and both groups were treated for 10 days.The recent efficacy,clinical symptom score,intestinal barrier function index,pancreatic function improvement and inflammation index of the two groups were compared.Results:The total effective rate of the short-term efficacy in the treatment group(80.00%)was significantly higher than that in the control group(53.33%)(P<0.05);the score of each clinical symptom in the treatment group after treatment was significantly lower than that in the control group(P<0.05);the DAO after treatment,D-lactic acid and endotoxin levels in the treatment group were significantly lower than the control group(P<0.05);the blood amylase recovery time and urine amylase recovery time in the treatment group were significantly shorter than the control group(P<0.05);the levels of IL-6,IL-10 and TNF-ɑin the treatment group were significantly better than the control group(P<0.05).Conclusion:Qingyi Decoction combined with external treatment of Chinese medicine has good curative effect on SAP,which can improve the clinical symptoms and intestinal barrier function of patients,reduce systemic inflammatory response,and promote the recovery of pancreatic function.