金藤大柴胡汤内服外敷联合足三里针刺治疗急性胰腺炎的临床疗效及对症状消失时间、血清因子、经济学效益的影响分析

Clinical Efficacy of Jinteng Dachaihu Decoction Taken Orally and Externally Combined with Zusanli Acupuncture in the Treatment of Acute Pancreatitis and Its Influence on the Time of Symptom Disappearance,Serum Factors and Economic Benefits

目的分析急性胰腺炎患者接受金藤大柴胡汤内服外敷联合足三里针刺治疗的临床疗效,及此联合诊疗方式对症状消失时间、血清因子、经济学效益的影响。方法选择2019年5月—2021年9月该院收治的80例急性胰腺炎患者作为研究对象,按盲选法,分为参照组(40例,接受常规治疗)和研究组(40例,在常规治疗基础上采用金藤大柴胡汤内服外敷联合足三里针刺治疗)。对比两组患者的病症缓解时间、血尿淀粉酶恢复时间、血清炎性因子;PCT、CT检测结果及总治疗费用。结果诊疗后,研究组患者的腹胀缓解时间为(5.02±1.02)d、腹痛缓解时间(4.12±1.12)d、肠鸣音缓解时间(3.56±1.35)d、尿淀粉酶恢复时间(3.45±0.83)d、血淀粉酶恢复时间(3.15±0.79)d,参照组分别为(6.75±1.21)、(5.57±1.26)、(5.83±1.44)、(6.36±1.02)、(5.78±1.01)d,研究组患者上述指标显著短于参照组,差异有统计学意义(t=6.914、5.440、7.274、13.996、12.972,P<0.05)。诊疗后,研究组肿瘤坏死因子(TN F-α)为(34.93±8.83)ng/L、白介素-6(IL-6)为(55.87±8.24)ng/L、白介素-8(IL-8)为(40.98±8.55)ng/L、超敏C-反应蛋白(hs-CRP)为(3.56±1.02)mg/L,参照组分别为(45.89±9.93)ng/L、(88.04±9.78)ng/L、(53.82±8.99)ng/L、(8.92±1.67)mg/L,研究组患者的上述指标显著低于参照组,差异有统计学意义(t=5.217、15.910、6.546、17.324,P<0.05)。诊疗后,研究组患者的血清降钙素(PCT)为(1.09±0.24)μg/L、CT检测最大截面积(3003.85±500.67)unit,参照组分别为(1.52±0.31)μg/L、(3593.32±532.86)unit,研究组患者的上述指标显著低于参照组,差异有统计学意义(t=6.937、5.098,P<0.05)。诊疗后,研究组总治疗费用(2504.83±584.67)元,参照组为(2294.84±530.86)元,组间对比差异无统计学意义(t=1.682,P>0.05)。结论将金藤大柴胡汤内服外敷联合足三里针刺治疗方式应用到急性胰腺炎的临床诊疗中,能提升患者的临床疗效,帮助患者缓解腹痛、腹胀等临床症状,缩短住院时间,降低医疗费用,值得基层医院推广应用。

Objective To analyze the clinical efficacy of Jinteng Dachaihu Decoction combined with Zusanli acupuncture treatment in patients with acute pancreatitis.And the effect of this combined diagnosis and treatment method on the time to symptom disappearance,serum factors,and economic benefits.Methods From May 2019 to September 2021,80 patients with acute pancreatitis admitted to the hospital were selected as the research objects.According to the blind selection method,they were divided into the reference group(40 cases,receiving conventional treatment)and the study group(40 cases,on the basis of conventional treatment,Jinteng Dachaihu Decoction was taken orally and externally combined with Zusanli acupuncture treatment).The time to remission of symptoms,recovery time of blood and urine amylase,serum inflammatory factors,serum calcitonin(PCT),CT test results and total treatment costs were compared between the two groups.Results After diagnosis and treatment,the relief time of abdominal distention,abdominal pain,bowel sound,urine amylase and blood amylase in the study group were(5.02±1.02)d,(4.12±1.12)d,(3.56±1.35)d,(3.45±0.83)d,(3.15±0.79)d,respectively,in the reference group were(6.75±1.21)d,(5.57±1.26)d,(5.83±1.44)d,(6.36±1.02)d,(5.78±1.01)d,respectively,the above indicators in the study group were significantly shorter than in the reference group,the difference was statistically significant(t=6.914,5.440,7.274,13.996,12.972,P<0.05).After treatment,the tumor necrosis factor(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)and hypersensitive C-reactive protein(hs-CRP)in the study group were(34.93±8.83)ng/L,(55.87±8.24)ng/L,(40.98±8.55)ng/L,(3.56±1.02)mg/L,respectively,the control group were(45.89±9.93)ng/L,(88.04±9.78)ng/L,(53.82±8.99)ng/L,(8.92±1.67)mg/L,respectively,the above indicators in the study group were significantly lower than those in the control group,the difference was statistically significant(t=5.217,15.910,6.546,17.324,P<0.05).After diagnosis and treatment,PCT and CT maximum cross-sectional area of patients in study group were(1.09±0.24)μg/L and(3003.85±500.67)unit,respectively,compared with(1.52±0.31)μg/L and(3593.32±532.86)unit in reference group,the above indicators in the study group were significantly lower than those in the reference group,the differences were statistically significant(t=6.937,5.098,P<0.05).After diagnosis and treatment,the total treatment cost of the study group was(2504.83±584.67)yuan,and that of the reference group was(2294.84±530.86)yuan,the difference was not between the two groups statistically significant(t=1.682,P>0.05).Conclusion The application of Jinteng Dachaihu Decoction internally and externally combined with Zusanli acupuncture treatment in the clinical diagnosis and treatment of acute pancreatitis can improve the clinical efficacy of patients,help patients relieve abdominal pain,abdominal distension and other clinical symptoms,shorten hospitalization time,and reduce medical expenses.It is worthy of promotion and application in primary hospitals.