丹参注射液联合日间连续性血液净化治疗重症急性胰腺炎临床研究

Clinical Study on Danshen Injection Combined with Daytime Continuous Blood Purification for Severe Acute Pancreatitis

目的:观察丹参注射液联合日间连续性血液净化治疗重症急性胰腺炎(SAP)的临床疗效。方法:选取SAP患者75例,按随机数字表法分为对照组37例和观察组38例。对照组采用日间连续性血液净化治疗,观察组在对照组基础上加用丹参注射液治疗。评价2组临床疗效,比较2组治疗前后血清淀粉酶(AMY)、降钙素原(PCT)、急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分、血清炎性因子[肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)]水平,记录临床症状改善时间,统计不良反应发生率。结果:观察组总有效率为97.37%,高于对照组81.08%(P<0.05)。治疗后,2组AMY、PCT、TNF-α、CRP、IL-6水平及APACHEⅡ评分较治疗前降低(P<0.05),且观察组降低程度高于对照组(P<0.05)。观察组体温恢复正常、呕吐恶心消失、腹痛腹胀消失和首次排便时间均短于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:丹参注射液联合日间连续性血液净化治疗SAP疗效显著,可有效改善患者临床症状,降低血清AMY及炎性因子水平,促进患者康复。

Objective:To observe the clinical effect of Danshen Injection combined with daytime continuous blood purification for severe acute pancreatitis(SAP).Methods:A total of 75 cases of SAP patients were divided into the control group and the observation group according to the random number table method,with 37 and 38 cases in each group respectively.The control group was treated with daytime continuous blood purification,and the observation group was additionally treated with Danshen Injection based on the treatment of the control group.The clinical effects in the two groups were evaluated.Before and after treatment,the amylase(AMY),procalcitonin(PCT)and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)scores,as well as the levels of inflammatory factors in serum including tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6)in the two groups were compared.The improvement time of clinical symptoms were recorded,and the incidence of adverse reactions was counted.Results:The total effective rate was 97.37% in the observation group,higher than that of 81.08% in the control group(P<0.05).After treatment,the levels of AMY,PCT,TNF-α,CRP and IL-6 and the APACHEⅡ scores in the two groups were decreased when compared with those before treatment(P<0.05),and the decrease degree in the observation group was higher than that in the control group(P<0.05).The time for temperature to return to normal,the disappearance time of vomiting and nausea as well as abdominal pain and abdominal distension,and the first defecation time in the observation group were shorter than those in the control group(P<0.05).There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Danshen Injection combined with daytime continuous blood purification has a significant curative effect in treating SAP,which can effectively improve clinical symptoms,reduce levels of AMY and inflammatory factors in serum,and promote the recovery of patients.