大黄牡丹汤治疗重症急性胰腺炎临床观察

Clinical Observation on Dahuang Mudan Decoction in the Treatment of Severe Acute Pancreatitis

目的探讨大黄牡丹汤对重症急性胰腺炎患者内毒素、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)及不良反应的影响。方法选取中国医科大学附属盛京医院2019年9月—2020年1月急性重症监护室收治的重症急性胰腺炎患者66例,随机分为试验组和对照组,各33例。对照组予以丙氨酰谷氨酰胺注射液100 mL静脉滴注,每日2次;试验组在对照组的基础上予以大黄牡丹汤治疗。比较患者临床疗效、脂质过氧化物(Lipid hydroperoxide,LPO)、超氧化物歧化酶(Superoxide dismutase,SOD)、过氧化氢酶(Catalase,CAT)、TNF-α、内毒素以及并发症发生情况。结果试验组治疗总有效率90.91%(30/33)高于对照组69.97%(23/33)(P<0.05);与对照组相比,试验组LPO、TNF-α、内毒素水平较低,SOD、CAT水平较高(P<0.05),试验组并发症发生率较低(P<0.05)。结论大黄牡丹汤治疗重症急性胰腺炎患者能抑制TNF-α的表达、减少肠道内毒素易位,清除机体自由基,有效改善患者临床症状,抑制机体的炎症反应。

Objective To investigate the effect of Dahuang Mudan decoction on endotoxin,TNF-αand adverse reactions in patients with severe acute pancreatitis.Methods 66 patients with severe acute pancreatitis in the acute intensive care unit(EICU)of Shengjing Hospital Affiliated to China Medical University were randomly divided into study group and control group,with 33 cases in each.The control group received alanyl glutamine injection 100ml iv,tid,and the study group received more with Dahuang Mudan decoction.The clinical efficacy,lipid peroxide(LPO),superoxide dismutase(SOD),catalase(CAT),tumor necrosis factor-α(TNF-α),endotoxin and complications were compared.Results The total effective rate of experimental group was 90.91%(30/33)higher than that of control group 69.97%(23/33)(P<0.05).Compared with the control group,the levels of LPO,TNF-αand endotoxin in experimental groups were lower,while the levels of SOD and CAT were higher(P<0.05),and the incidence of complications in experimental groups was lower(P<0.05).Conclusion Dahuang Mudan decoction can inhibit the expression of TNF-α,reduce the translocation of intestinal endotoxin,clear free radicals,effectively improve the clinical symptoms of patients with severe acute pancreatitis and inhibit the inflammatory reaction of the body.