大黄素联合奥曲肽对急性胰腺炎的疗效及血清水通道蛋白的影响

Effect of emodin combined with octreotide in the treatment of acute pancreatitis and its influence on serum aquaporin levels

目的探讨大黄素联合奥曲肽治疗急性胰腺炎(AP)的疗效及对血清水通道蛋白5(AQP5)、水通道蛋白6(AQP6)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平的影响。方法将114例AP患者采用随机数字表法均分为观察组与对照组,每组57例。2组患者均接受基础治疗,对照组给予奥曲肽治疗,观察组加用大黄素辅助治疗。比较2组的临床疗效,治疗前后测评急性生理功能与慢性健康评分(APACHEⅡ)、改良CT严重指数(MCTSI)、血清淀粉酶(AMY)、脂肪酶(LIP)、AQP5、AQP6、IL-6和TNF-α水平。结果观察组总有效率(96.49%)高于对照组(84.21%),P<0.05。观察组的退热时间、止吐时间、腹痛消失时间、腹胀消失时间、排气恢复时间、AMY正常时间和LIP正常时间均短于对照组(P<0.05)。治疗后,观察组的APACHEⅡ评分、MCTSI评分、血清AMY、LIP、IL-6和TNF-α水平均低于对照组,AQP5和AQP6水平均高于对照组(P<0.05)。2组并发症发生率及死亡率比较差异无统计学意义(P>0.05)。结论大黄素联合奥曲肽治疗AP疗效确切,能够改善临床症状并减轻病情,其机制可能与上调AQP5、AQP6和下调IL-6、TNF-α等有关。

Objective To investigate the efficacy of emodin combined with octreotide in the treatment of acute pancreatitis(AP)and influence on serum levels of aquaporin 5(AQP5),aquaporin 6(AQP6),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α).Methods 114 patients with AP were randomly divided into observation group and control group,with 57 cases in each group.The 2 groups received basic treatment,the control group was treated with octreotide,and the observation group was treated with emodin on the basis of control group.The clinical efficacy of the 2 groups was compared.The Acute Physiology and Chronic Health Evaluation(APACHEⅡ),modified CT severity index(MCTSI),serum amylase(AMY),lipase(LIP),AQP5,AQP6,IL-6 and TNF-αwere measured before and after treatment.Results The total effective rate of the observation group was higher than that of the control group(96.49%vs 84.21%,P<0.05).The antipyretic time,antiemetic time,time of abdominal pain disappearance,time of abdominal distension disappearance,exhaust recovery time,AMY normal time and LIP normal time in the observation group were shorter than in the control group(P<0.05).After treatment,the APACHEⅡscore,MCTSI score,serum levels of AMY,LIP,IL-6 and TNF-αin the observation group were lower than those in the control group,and the AQP5 and AQP6 levels were higher than in the control group(P<0.05).There was no significant difference in the incidence of total complication and mortality between the 2 groups(P>0.05).Conclusion Emodin combined with octreotide is effective in the treatment of AP,which can improve the clinical symptoms and alleviate the disease.The mechanism may be related to the up-regulation of AQP5,AQP6 and down-regulation of IL-6 and TNF-α.