中药清肝利胆汤在重症急性胰腺炎治疗中的作用

Role of Chinese Herbal Qinggan Lidan Decoction in the Treatment of Severe Acute Pancreatitis

目的 采用中药汤剂清肝利胆汤对重症急性胰腺炎(severe acute pancreatitis,SAP)进行临床治疗,分析在应用清肝利胆汤后患者的治疗情况。方法 方便选取2021年8月—2022年5月牡丹江医学院附属二院进行临床住院治疗的42例SAP患者为研究对象,该42例患者均出现胰腺组织感染坏死状况。对照组(n=21)进行常规治疗,观察组(n=21)则在应用常规治疗的基础上联合中药清肝利胆汤进行临床治疗。对比两组患者治疗前后中医证候积分、炎性因子变化情况、肠道优势菌群菌落含量、并发症发生率和治疗有效率。结果治疗后,观察组中医证候总积分明显低于对照组,差异有统计学意义(P<0.05)。在炎性因子检测当中,观察组患者的血清淀粉酶(serum amylase,AMS)、脂肪酶(lipase,LPS)、C反应蛋白(C-reaction protein,CRP)以及肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)明显低于对照组,差异有统计学意义(P<0.05)。观察组肠球菌优势菌群数量低于对照组,乳酸杆菌与双歧杆菌菌群增长数量更优于对照组,差异有统计学意义(P<0.05)。观察组患者的SAP并发症发生率为9.52%,低于对照组的38.10%,差异有统计学意义(χ^(2)=4.725,P<0.05)。观察组总有效率为95.24%高于对照组的66.67%,差异有统计学意义(χ^(2)=3.860,P<0.05)。结论 采用中药清肝利胆汤对SAP患者进行临床治疗具有较好的治疗效果,值得在临床中广泛推广应用。

Objective Qinggan Lidan Decoction was used to treat severe acute pancreatitis(SAP),and the treatment of patients after the application of Qinggan Lidan Decoction was analyzed.Methods A total of 42 patients with SAP who were hospitalized in the Second Affiliated Hospital of Mudanjiang Medical College from August 2021 to May 2022were conveniently selected as the research objects.All 42 patients had pancreatic tissue infection and necrosis.The control group(n=21) was treated with routine treatment,while the observation group(n=21) was treated with Qinggan Lidan Decoction on the basis of routine treatment.The scores of TCM syndromes,changes of inflammatory factors,colony content of intestinal dominant flora,incidence of complications and effective rate of treatment were compared between the two groups before and after treatment.Results After treatment,the total score of TCM syndromes in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).In the detection of inflammatory factors,serum amylase(AMS),lipase(LPS),C-reaction protein(CRP),tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The number of dominant flora of Enterococcus in the observation group was lower than that in the control group,and the growth of Lactobacillus and Bifidobacterium flora was better than that in the control group,the difference was statistically significant(P<0.05).The incidence of SAP complications in the observation group was 9.52%,which was lower than 38.10% in the control group,and the difference was statistically significant(χ^(2)=4.725,P<0.05).The total effective rate of the observation group(95.24%) was higher than that of the control group(66.67%),and the difference was statistically significant(χ^(2)=3.860,P<0.05).Conclusion The clinical treatment of patients with SAP by using traditional Chinese herbal Qinggan Lidan decoction has better therapeutic effect,and is worth to be widely popularized and applied in the clinic.