醋酸奥曲肽结合大承气汤治疗对急性胰腺炎患者炎症细胞因子水平与肠功能恢复的影响

Effect of octreotide acetate combined with Dachengqi Decoction on inflammatory cytokine level and intestinal function recovery in patients with acute pancreatitis

目的研究醋酸奥曲肽结合大承气汤治疗对急性胰腺炎患者炎症细胞因子水平与肠功能恢复的影响。方法84例急性胰腺炎患者,以双盲法分为对照组和研究组,各42例。对照组进行醋酸奥曲肽治疗,研究组在对照组基础上联合大承气汤治疗。比较两组患者治疗前后炎症细胞因子、肠道功能评分量表(GIF)分级、肠功能恢复情况、不良反应发生率。结果治疗后,两组C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均较治疗前降低,且研究组患者CRP(74.85±9.67)mg/L、IL-6(24.59±4.64)ng/L、TNF-α(3.93±0.51)pg/ml均低于对照组的(107.94±11.37)mg/L、(53.02±8.57)ng/L、(6.82±0.46)pg/ml,差异均具有统计学意义(P<0.05)。两组经过治疗后肠道功能评分量表(GIF)分级下降,研究组患者GIF 1级占比78.57%高于对照组的52.38%,GIF 2级占比19.05%低于对照组的40.48%,差异均具有统计学意义(P<0.05)。研究组患者排便、排气、肠鸣音恢复、腹痛缓解以及腹胀缓解时间均短于对照组,差异均具有统计学意义(P<0.05)。研究组不良反应发生率9.52%与对照组的7.14%比较,差异无统计学意义(P>0.05)。结论急性胰腺炎患者在醋酸奥曲肽治疗基础上联合大承气汤能够促进炎症反应减轻,加快肠功能恢复,中西医结合治疗未增加药物不良反应,值得推广。

Objective To study the effect of octreotide acetate combined with Dachengqi Decoction on inflammatory cytokine level and intestinal function recovery in patients with acute pancreatitis.Methods A total of 84 patients with acute pancreatitis were divided into control group and research group according to doubleblind method,with 42 cases in each group.The control group was treated with octreotide acetate,and the research group was treated with Dachengqi Decoction on the basis of the control group.The inflammatory cytokines before and after treatment,gastrointestinal failure(GIF)grading,recovery of intestinal function,and incidence of adverse reactions were compared between the two groups.Results After treatment,the levels of C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)of the two groups were lower than those before treatment,and CRP(74.85±9.67)mg/L,IL-6(24.59±4.64)ng/L and TNF-α(3.93±0.51)pg/ml of the research group were lower than(107.94±11.37)mg/L,(53.02±8.57)ng/L and(6.82±0.46)pg/ml of the control group.All the difference was statistically significant(P<0.05).After treatment,the GIF grading of the two groups decreased.The proportion of GIF grade 1 in the research group was 78.57%,which was higher than 52.38%in the control group,and the proportion of GIF grade 219.05%was lower than 40.48%in the control group.All the differences were statistically significant(P<0.05).The defecation time,exhaust time,bowel sound recovery time,abdominal pain relief time and abdominal distension relief time of the research group were shorter than those of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the research group was 9.52%,which was not statistically significant compared with 7.14%in the control group(P>0.05).Conclusion Combination of octreotide acetate and Dachengqi Decoction for patients with acute pancreatitis can reduce inflammation reactions,accelerate the recovery of bowel function,and integrated Chinese and western medicine treatment does not increase adverse drug reactions.It is worthy of promotion.