大柴胡汤加减联合醋酸奥曲肽注射液治疗重症急性胰腺炎的效果及对血清肿瘤坏死因子水平的影响

Efficacy of Modified Dachaihu Decoction combined with Octreotide Acetate Injection in the treatment of severe acute pancreatitis and its ibfluence on the level of serum tumor necrosis factor

目的探讨大柴胡汤加减联合醋酸奥曲肽注射液治疗重症急性胰腺炎的效果及对血清肿瘤坏死因子水平的影响。方法选取2018年1月至2020年12月厦门大学附属福州第二医院收治的80例重症急性胰腺炎患者作为研究对象,按照随机数字表法分为对照组(40例)与观察组(40例)。对照组采用醋酸奥曲肽注射液治疗,观察组在对照组的基础上采用大柴胡汤加减治疗。比较两组的治疗效果、不良反应发生率、肠道黏膜屏障功能和血清肿瘤坏死因子水平。结果观察组的治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组的不良反应总发生率低于对照组,差异有统计学意义(P<0.05);两组治疗后的血浆内毒素、血浆二胺氧化酶、尿乳果糖/甘露醇水平低于治疗前,差异有统计学意义(P<0.05)。观察组治疗后的血浆内毒素、血浆二胺氧化酶、尿乳果糖/甘露醇水平低于对照组,差异有统计学意义(P<0.05)。两组治疗后的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平低于治疗前,差异有统计学意义(P<0.05)。观察组治疗后的IL-6、TNF-α、IL-8水平低于对照组,差异有统计学意义(P<0.05)。结论对重症急性胰腺炎采用大柴胡汤加减联合醋酸奥曲肽注射液治疗可提高治疗有效率,显著改善患者的肠道黏膜屏障功能和血清肿瘤坏死因子水平,值得临床推广使用。

Objective To explore the effect of modified Dachaihu Decoction combined with Octreotide Acetate Injection in the treatment of severe acute pancreatitis and its influence on the level of serum tumor necrosis factor.Methods From January 2018 to December 2020,80 patients with severe acute pancreatitis who were admitted to Fuzhou Second Hospital Affiliated to Xiamen University were selected as the study subjects.According to the random number table method,they were divided into the control group(40 cases)and the observation group(40 cases).The control group was treated with Octreotide Acetate Injection,and the observation group was treated with Modified Dachaihu Decoction on the basis of the treatment of the control group.The therapeutic effects,the incidence rate of adverse reactions,intestinal mucosal barrier function,and the level of serum tumor necrosis factor were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The total incidence rate of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The levels of plasma endotoxin,plasma diamine oxidase and urinary lactulose/mannitol in the two groups after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).The levels of plasma endotoxin,plasma diamine oxidase and urinary lactulose/mannitol in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interleukin-8(IL-8)after treatment in the two groups were lower than those before treatment,and the differences were statistically significant(P<0.05).The levels of IL-6,TNF-α and IL-8 in the observation group after treatment were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Modified Dachaihu Decoction combined with Octreotide Acetate Injection in the treatment of severe acute pancreatitis can improve the effective rate of treatment,and significantly improve patients′intestinal mucosal barrier function and level of serum tumor necrosis factor,which is worthy of clinical popularization and application.