通腑解毒方联合六合丹辅助西医治疗急性胰腺炎临床研究

Clinical study of Tongfu Jiedu recipe combined with Liuhe Dan assisted western medicine in treating acute pancreatitis

目的:观察通腑解毒方联合六合丹辅助西医治疗急性胰腺炎的临床疗效及对患者肠功能屏障、肝功能、炎症反应的影响。方法:将157例急性胰腺炎患者采用简单随机法分为西医组(n=78)和辨证组(n=79)。西医组给予西医治疗,辨证组在西医组治疗基础上给予通腑解毒方灌肠联合六合丹外敷治疗。比较两组临床相关指标、中医症候积分、疗效、28 d病死率、血清学指标。结果:辨证组总有效率高于西医组,腹痛、腹胀缓解时间及首次排便时间、进食时间均短于西医组(均P<0.05)。治疗后,两组各项中医症候积分较治疗前下降,且辨证组低于西医组(均P<0.05)。治疗后,两组血、尿淀粉酶及二胺氧化酶(DAO)、D-乳酸、谷草转氨酶(AST)、C反应蛋白(CRP)、单核细胞趋化因子-1(MCP-1)、谷丙转氨酶(ALT)水平均较治疗前下降,且辨证组低于西医组(均P<0.05)。两组28 d病死率比较,差异无统计学意义(P>0.05)。结论:通腑解毒方联合六合丹辅助西医治疗急性胰腺炎可促进腹痛、腹胀的缓解,保护肠功能屏障,抑制炎症反应,提高疗效。

Objective:To observe the clinical efficacy of Tongfu Jiedu recipe combined with Liuhe Dan in the treatment of acute pancreatitis and its effect on intestinal functional barrier,liver function and inflammatory response.Methods:157 patients with acute pancreatitis were randomly divided into western medicine group(n=78)and syndrome differentiation group(n=79).The western medicine group was treated with western medicine,while the syndrome differentiation group was treated with Tongfu Jiedu recipe combined with Liuhe Dan on the basis of western medicine group.Clinical indicators,TCM symptom score,curative effect,28 day mortality and serological indicators were compared between the two groups.Results:The total effective rate of the syndrome differentiation group was higher than that of the western medicine group,and the relieving time of abdominal pain and abdominal distension,the time of first defecation and eating were shorter than those of the western medicine group(P<0.05).After treatment,the scores of TCM symptoms in both groups were lower than before treatment,and the syndrome differentiation group was lower than the western medicine group(P<0.05).After treatment,blood and urine amylase,diamine oxidase(DAO),D-lactic acid,asthenic-oxalic aminotransferase(AST),C-reactive protein(CRP),monocyte chemokine-1(MCP-1),alanine aminotransferase(ALT)were decreased in two groups compared with before treatment,and the syndrome differentiation group was lower than western medicine group(P<0.05).There was no significant difference in the 28 day mortality between the two groups(P>0.05).Conclusion:Tongfu Jiedu recipe combined with Liuhe Dan assisted western medicine in the treatment of acute pancreatitis can promote the relief of abdominal pain and abdominal distension,protect intestinal functional barrier,inhibit inflammatory response and improve the curative effect.