中药柴胡疏肝散加减治疗慢性胰腺炎对胰腺外分泌功能及胰腺纤维化的影响研究

Influence of Chaihu Shugan Powder on Pancreatic Exocrine Function and Pancreatic Fibrosis in Treating Chronic Pancreatitis

目的探讨中药柴胡疏肝散加减治疗慢性胰腺炎的临床疗效,及对胰腺外分泌功能、胰腺纤维化的影响。方法选取2017年3月—2018年10月期间青海省第四人民医院收治的慢性胰腺炎患者86例,采用随机数字表法分为对照组和观察组,每组各43例。对照组患者实施常规西医治疗,观察组患者在对照组基础上加用中药柴胡疏肝散。治疗4周后,观察比较两组患者治疗前后的临床症状、体征、中医证候积分以及血清胆囊收缩素(Cholecystokinin,CCK)、血清肿瘤坏死因子-α(Tumor necrosis factor-alpha,TNF-α)、转化生长因子β1(Transforming growth factorβ1,TGF-β1)水平变化,临床疗效及不良反应情况。结果治疗后两组患者各项中医证候积分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组治疗后的腹痛、腹胀、恶心、呕吐评分均较对照组明显降低,差异有统计学意义(P<0.05)。观察组患者腹胀缓解时间、腹痛缓解时间及肠鸣音恢复时间均明显短于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清CCK、TNF-α及TGF-β1水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组治疗后血清CCK、TNF-α及TGF-β1水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组患者总有效率为93.02%(40/43)明显高于对照组总有效率74.42%(32/43),差异有统计学意义(P<0.05)。治疗期间,两组患者均未发生不良反应。结论中药柴胡疏肝散加减治疗慢性胰腺炎能够有效改善胰腺外分泌功能,降低TGF-β1、TNF-α表达,减轻胰腺纤维化造成的病理损害,缓解临床症状、体征,从而提高临床治疗效果。

Objective To investigate the clinical effect of Chaihu Shugan Powder on chronic pancreatitis and its influence on pancreatic exocrine function and pancreatic fibrosis.Methods A total of 86 patients with chronic pancreatitis who were admitted to the Fourth People′s Hospital of Qinghai Province from March 2017 to October 2018 were selected and divided into a control group and an observation group by random number table method,with 43 cases in each group.The patients in the control group were treated with conventional western medicine,and the patients in the observation group were additionally treated with traditional Chinese medicine Chaihu Shugan Powder on the basis of the control group.After 4 weeks of treatment,the clinical symptoms,signs,serum cholecystokinin(CCK),serum tumor necrosis factor-alpha(TNF-α),transforming growth factorβ1,(Transforming growth factorβ1,TGF-β1)level changes,clinical efficacy and adverse reactions of the two groups of patients before and after treatment were observed and compared.Results After treatment,the scores of various TCM syndromes in the two groups were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).decreased,and the difference was statistically significant(P<0.05).The abdominal distension relief time,abdominal pain relief time and bowel sound recovery time in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of serum CCK,TNF-αand TGF-β1 in the two groups were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the total effective rate in the observation group was 93.02%(40/43),which was significantly higher than that in the control group,which was 74.42%(32/43),and the difference was statistically significant(P<0.05).During the treatment period,there were no adverse reactions in the two groups.Conclusion Chaihu Shugan Powder can effectively improve the exocrine function of pancreas,reduce the expression of TNF-αand TGF-β1,alleviate the pathological damage caused by pancreatic fibrosis,alleviate clinical symptoms and signs,and improve the clinical therapeutic effect.