中医通里攻下法联合早期微生态肠内营养治疗重症急性胰腺炎的临床效果及对炎症反应的影响

Effect of Tongli Gongxia Method Combined with Early Microecological Enteral Nutrition in Treatment of Severe Acute Pancreatitis and Its Influence on Inflammatory Reaction

目的探讨中医通里攻下法联合早期微生态肠内营养治疗重症急性胰腺炎的临床效果及对炎症反应的影响。方法选择2020年1月—2020年9月医院收治的重症急性胰腺炎患者72例,按随机数字表法分为观察组和对照组,各36例。对照组在常规治疗基础上给予早期微生态营养制剂进行肠内营养,观察组在对照组基础上给予中医通里攻下法治疗,连续治疗2周。比较两组治疗后腹胀、腹痛缓解时间、胃肠道功能恢复时间,比较两组治疗前后白介素-6(IL-6)、白介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)等炎症因子水平;同时比较两组干预效果。结果观察组腹胀及腹痛缓解时间、胃肠道功能恢复时间明显短于对照组,差异有统计学意义(P<0.05);治疗后,观察组IL-6、IL-8及TNF-α水平均低于对照组,差异有统计学意义(P<0.05);观察组总有效率91.7%,高于对照组69.4%,差异有统计学意义(χ^(2)=4.345,P=0.037)。结论中医通里攻下法联合早期微生态肠内营养治疗重症急性胰腺炎,可以抑制炎症反应,快速缓解患者临床症状,提高临床效果,值得进一步探讨。

Objective To investigate the clinical effect of Tongli Gongxia method combined with early microecological enteral nutrition in the treatment of severe acute pancreatitis(SAP)and its influence on inflammatory reaction.Methods Seventy-two patients with severe acute pancreatitis in our hospital from January to September 2020 were selected and randomly divided into observation group and control group,36 cases in each group.On the basis of conventional treatment,the control group was given early microecological nutrition for enteral nutrition,while the observation group was given Tongli Gongxia method of traditional Chinese medicine for 2 weeks.The abdominal distension,abdominal pain relief time and gastrointestinal function recovery time were compared between the two groups.The levels of interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor were compared between the two groups before and after treatment.At the same time,the intervention effects of the two groups were compared.Results The remission time of abdominal distension and abdominal pain and recovery time of gastrointestinal function in the observation group were significantly shorter than those in the control group(P<0.05).After treatment,the levels of IL-6,IL-8 and TNF-αin the observation group were significantly lower than those in the control group.The difference was statistically significant(P<0.05).The total effective rate of the observation group was 91.7%,higher than 69.4%of the control group.The difference was statistically significant(χ;=4.345,P=0.037).Conclusion TCM Tongli Gongxia method combined with early microecological enteral nutrition in the treatment of severe acute pancreatitis can inhibit the inflammatory reaction,quickly relieve the clinical symptoms and improve the clinical effect,worthy of further discussion.