通腑清胰加减方中药灌肠在重症急性胰腺炎中的应用价值

Study on the application value of traditional chinese medicine enema of Tongfu Qingyi Decoction in severe acute pancreatitis

目的研究通腑清胰加减方中药灌肠治疗重症急性胰腺炎(Severe acute pancreatitis,SAP)的临床价值。方法选择2020年2月至2022年9月无锡市新吴区新瑞医院150例SAP患者,按随机数字表法分为对照组(n=75)与观察组(n=75)。对照组患者给予常规西医治疗,观察组患者常规西医治疗基础上给予通腑清胰加减方中药灌肠。比较两组患者临床疗效、病情评分[急性生理与慢性健康-Ⅱ(APACHEⅡ)、Balthazar CT评分]、预后及炎症因子[C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、细胞间黏附分子-1(Intercellular adhesion molecule-1,ICAM-1)]水平。结果(1)治疗后两组患者CRP、TNF-α、IL-6、ICAM-1水平均较治疗前下降(P<0.05),且观察组患者CRP、TNF-α、IL-6、ICAM-1水平低于对照组患者,差异均有统计学意义(P<0.05);(2)观察组疾病总有效率、证候总有效率均高于对照组(P<0.05);(3)观察组患者APACHEⅡ、Balthazar CT分值低于对照组患者,住院时长短于对照组患者,28 d病死率低于对照组患者(P<0.05)。结论采取通腑清胰加减方中药灌肠治疗SAP可取得良好效果,具有推广价值。

ObjectiveTo study the clinical value of traditional Chinese medicine enema of Tongfu Qingyi Decoction in the treatment of severe acute pancreatitis(SAP).Methods150 SAP patients from Xinrui Hospital,Xinwu District,Wuxi city from February 2020 to September 2022 were randomly divided into control group(n=75)and observation group(n=75).The control group was given conventional Western medicine treatment,and the observation group was given TCM enema with Tongfu Qingyi Jiajian formula based on conventional Western medicine treatment.Compare the clinical efficacy,disease score[APACHEⅡ,Balthazar CT score],prognosis and inflammatory factors[C-reactive protein(CRP),tumor necrosis factor(TNF)between the two groups-α(Tumor necrosis factor-α,TNF-α)、Interleukin-6(IL-6),intercellular adhesion molecule-1(ICAM-1)].Results(1)After treatment,the levels of CRP,TNF-α,IL-6 and ICAM-1 in the two groups were decreased compared with those before treatment(P<0.05),and the levels of CRP,TNF-α,IL-6 and ICAM-1 in the observation group were lower than those in the control group,with statistical significance(P<0.05).(2)The total effective rate of disease and syndrome in observation group was higher than that in control group(P<0.05).(3)The APACHEⅡand Balthazar CT scores in the observation group were lower than those in the control group,the length of hospitalization was shorter than that in the control group,and the 28 day mortality was lower than that in the control group(P<0.05).ConclusionThe treatment of SAP with traditional chinese medicine enema of Tongfu Qingyi plus or minus formula can achieve good results and has promotion value.