清胰逐瘀攻毒方治疗急性胆源性胰腺炎临床疗效及对炎症因子、p38MAPK蛋白表达水平的影响

Clinical Effect of Qingyi Zhuyu Gongdu Prescription for Acute Biliary Pancreatitis and Its Influence on Levels of Inflammatory Factors and p38MAPK Protein Expression

目的:观察清胰逐瘀攻毒方联合常规治疗急性胆源性胰腺炎的临床疗效及对血清炎症因子、丝裂原活化蛋白激酶p38 (p38MAPK)蛋白表达水平的影响。方法:选取120例急性胆源性胰腺炎患者作为研究对象,采用随机数字表法分为对照组和研究组各60例。对照组给予常规治疗,研究组在对照组基础上给予清胰逐瘀攻毒方治疗。治疗7 d后,比较2组临床疗效及不良反应情况,以及2组治疗前后中医证候积分、胰腺外分泌功能[血淀粉酶(AMY)、尿淀粉酶(UAMY)]、炎症因子[降钙素原(PCT)、可溶性细胞间黏附分子-1 (sICAM-1)、肿瘤坏死因子-α (TNF-α)、白细胞介素-8 (IL-8)]及p38MAPK蛋白表达水平。结果:研究组总有效率为90.00%,对照组73.33%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组恶心呕吐、胸脘痞满、腹痛拒按、口干口渴、大便黏结、小便短赤或短涩等中医证候评分均较治疗前降低(P<0.05),且研究组上述各项评分均低于对照组(P<0.05)。治疗后,2组AMY、UAMY水平均较治疗前降低(P<0.05),且研究组AMY、UAMY水平均低于对照组(P<0.05)。治疗后,2组血清PCT、TNF-α、IL-8、sICAM-1、p38MAPK蛋白表达水平均较治疗前降低(P<0.05),且研究组上述各项指标均低于对照组(P<0.05)。治疗期间,2组均未出现严重不良反应。结论:清胰逐瘀攻毒方辅助治疗急性胆源性胰腺炎效果确切,能够有效减轻临床症状,改善胰腺外分泌功能,下调血清炎症因子及p38MAPK蛋白表达水平,且安全性良好。

Objective:To observe the clinical effect of Qingyi Zhuyu Gongdu Prescription combined with conventional treatment on acute biliary pancreatitis and its influence on levels of serum inflammatory factors and mitogen-activated protein kinase p38(p38MAPK) protein expression.Methods:A total of 120 patients with acute biliary pancreatitis were selected as the study objects,and were divided into the control group and the study group by random number table method,with 60 cases in each group.The control group received conventional treatment,and the study group was additionally treated with Qingyi Zhuyu Gongdu Prescription based on the treatment of the control group.After seven days of treatment,the clinical effects and the accurrence of adverse reactions in the two groups were compared.The traditional Chinese medicine(TCM) syndrome scores,pancreatic exocrine function,including serum amylase(AMY)and urine amylase(UAMY),levels of inflammatory factors,including procalcitonin(PCT),soluble intercellular adhesion molecule-1(sICAM-1),tumor necrosis factor-α(TNF-α) and interleukin-8(lL-8),and levels of p38MAPK protein expression before and after treatment were compared between the two groups.Results:The total effective rate was 90.00% in the study group and 73.33% in the control group,there being significant difference between the two groups(P<0.05).After treatment,the TCM syndrome scores such as nausea and vomiting,impediment and fullness of chest and stomach cavity,abdominal pain which refuses pressure,dry mouth and thirst,sticky stool,short and dark urine or short and painful urination in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the study group were lower than those in the control group(P<0.05).After treatment,the AMY and UAMY levels in the two groups were decreased when compared with those before treatment(P<0.05),and the AMY and UAMY levels in the study group were lower than those in the control group(P<0.05).After treatment,the protein expression levels of serum PCT,TNF-α,lL-8,sICAM-1 and p38MAPK in the two groups were decreased when compared with those before treatment(P<0.05),and the above levels in the study group were lower than those in the control group(P<0.05).During treatment,no serious adverse reactions occurred in both groups.Conclusion:Qingyi Zhuyu Gongdu Prescription has a definite effect on the adjuvant treatment of acute biliary pancreatitis,which can effectively reduce clinical symptoms,improve pancreatic exocrine function,regulate serum inflammatory factors and p38MAPK protein expression level,with great safety.