柴芍承气汤对重症急性胰腺炎患者生存质量及IL-6水平的影响

Effect of Chaishao Chengqi Decoction on the Quality of Life and the IL-6 Level in Severe Acute Pancreatitis Patients

目的:探究柴芍承气汤治疗对重症急性胰腺炎患者生存质量及预后的影响。方法:选取2013年8月-2022年1月在重症医学科住院的重症急性胰腺炎患者120例,按随机数字表法将其分为对照组和治疗组,各60例。对照组采用常规西医治疗方法,治疗组给予柴芍承气汤联合常规西医治疗。观察两组患者治疗后的生存率、生存质量、血清白介素-6(IL-6)水平及免疫功能的变化。结果:治疗组患者治疗后有12例生活质量稳定,43例生活质量升高,5例生活质量下降;对照组治疗后有26例生活质量稳定,11例生活质量升高,23例生活质量下降。两组生活质量比较,差异有统计学意义(P<0.05)。治疗后,治疗组NK、CD4^(+)/CD8^(+)均较治疗前升高(P<0.05);对照组NK较治疗前降低(P<0.05);对照组CD4^(+)/CD8^(+)治疗前和治疗后比较,差异无统计学意义(P>0.05);治疗后,治疗组NK、CD4^(+)/CD8^(+)均高于对照组(P<0.05)。两组患者血清IL-6水平随治疗时间增加逐渐递减。治疗第7天IL-6均低于治疗第1、2、3天的水平(P<0.05),治疗组第1、2、3、7天的IL-6均明显低于对照组(P<0.05)。对照组患者经过治疗后生存率为68.3%,低于治疗组的86.7%,差异有统计学意义(P<0.05)。结论:柴芍承气汤可促进CD4^(+)/CD8^(+)比值升高,改善NK细胞的活性,抑遏血清IL-6水平,从而改善重症急性胰腺炎患者的生存率及生存质量,可能是其作用机制之一。

Objective:To investigate the effect of Chaishao Chengqi Decoction on quality of life and prognosis of patients with severe acute pancreatitis.Method:A total of 120 patients with severe acute pancreatitis hospitalized in icu from August 2013 to January 2022 were selected and divided into control group and treatment group according to random number table method,with 60 cases in each group.The control group was treated with conventional western medicine,and the treatment group was treated with Chaishao Chengqi Decoction combined with conventional western medicine.The survival rate,quality of life,serum interleukin-6 level(IL-6)and immune function of two groups were observed after treatment.Result:In the treatment group,the quality of life was stable in 12 cases,increased in 43 cases and decreased in 5 cases;in the control group,the quality of life was stable in 26 cases,increased in 11 cases and decreased in 23 cases.Comparison of quality of life between the two groups,the difference was statistically significant(P<0.05).After treatment,NK and CD4^(+)/CD8^(+)in the treatment group were increased compared with before treatment(P<0.05),NK in control group was lower than before treatment(P<0.05).There was no significant difference in CD4^(+)/CD8^(+)before and after treatment in the control group(P>0.05).After treatment,NK and CD4^(+)/CD8^(+)in the treatment group were higher than those in the control group(P<0.05).Serum IL-6 levels in both groups gradually decreased with the increase of treatment time.The level of IL-6 on the 7th d of treatment was lower than that on the 1st,2nd and 3rd d of treatment(P<0.05),and the level of IL-6 in the 1st,2nd,3rd and 7th d of treatment group were significantly lower than those in the control group(P<0.05).After treatment,the survival rate of control group was 68.3%,lower than 86.7%of treatment group,the difference was statistically significant(P<0.05).Conclusion:Chaishao Chengqi Decoction can promote the increase of CD4^(+)/CD8^(+)ratio,improve the activity of NK cells and inhibit the level of serum IL-6,so as to improve the survival rate and quality of life of patients with severe acute pancreatitis,which may be one of its mechanisms.