针灸联合清胰汤灌肠治疗急性胰腺炎临床观察

Clinical Observation of Acupuncture Combined with Qingyi Decoction Enema in the Treatment of Acute Pancreatitis

目的观察针灸联合清胰汤灌肠治疗急性胰腺炎的临床疗效。方法70例急性胰腺炎患者采用随机数字表法分为观察组与对照组各35例。对照组予西医常规治疗,观察组在对照组基础上加予针灸联合清胰汤灌肠治疗。观察两组患者临床疗效,症状及体征恢复时间,胃肠功能及炎性因子表达。结果观察组血尿淀粉酶、症状及体征恢复时间均显著低于对照组(P<0.05);治疗后,两组患者Marshall评分、Balthazar CT评分及急性生理与慢性健康状况(APACHEⅡ)评分均较治疗前显著改善(P<0.05),组间比较,观察组改善均显著优于对照组(P<0.05);两组肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)水平均较治疗前显著下降,白细胞介素-10(IL-10)较治疗前显著上升(P<0.05);组间比较,观察组TNF-α、IL-1、IL-6显著低于对照组,而IL-10显著高于对照组(P<0.05);观察组总有效率为91.43%,显著高于对照组的74.28%(P<0.05)。结论针灸联合清胰汤灌肠能够有效促进急性胰腺炎患者胃肠功能恢复,缓解腹痛腹胀症状,提高临床疗效,其机制可能与该方案能抑制促炎因子释放并促进抗炎因子合成,从而调控机体炎症反应有关。

Objective:To investigate the clinical efficacy of acupuncture combined with Qingyi Decoction enema in the treatment of acute pancreatitis.Methods:A total of 70 cases of acute pancreatitis patients were selected and randomly divided into the control group and observation group,35 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with acupuncture combined with Qingyi Decoction enema on the basis of the control group.The curative effect,recovery time of symptoms and signs,gastrointestinal function and expression of inflammatory factors were observed.Results:The recovery time of blood and urine amylase,symptoms and signs in the observation group were significantly lower than those in the control group(P<0.05);after treatment,the Marshall score,Balthazar CT score,and acute physiology and chronic health(APACHEⅡ)scores of the two groups were significantly improved compared with before treatment(P<0.05),and the improvement of the observation group was significantly better than that of the control group(P<0.05);after treatment,the tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),interleukin-6(IL-6)levels of the two groups were significantly lower than before treatment,and interleukin-10(IL-10)was significantly higher than before treatment(P<0.05);comparison between groups,the levels of TNF-α,IL-1,IL-6 in the observation group were significantly lower than the control group,while IL-10 was significantly higher than the control group(P<0.05);the total effective rate of the observation group was 91.43%,which was significantly higher than 74.28%of the control group(P<0.05).Conclusion:Acupuncture combined with Qingyi Decoction enema can effectively promote the recovery of gastrointestinal function in patients with acute pancreatitis,relieve abdominal pain and abdominal distension symptoms,and improve the clinical efficacy.The mechanism may be related to the inhibition of proinflammatory factor release and the promotion of anti-inflammatory factor synthesis,thus regulating the body′s inflammatory response.