胰炎消方辅助治疗急性胰腺炎的疗效及对sFlt-1、α-MSH的影响

Efficacy of Yiyanxiao Formula in adjuvant treatment of acute pancreatitis and its effects on sFlt-1 andα-MSH

目的探讨中药胰炎消方辅助治疗急性胰腺炎(acutepancreatitis,AP)的临床疗效。方法选择秦皇岛市中医医院重症医学科2021年3月至2022年10月期间收治的AP患者104例,按照随机数字表法分为观察组和对照组,各52例。对照组实施西医治疗,观察组在此基础上予以中药胰炎消方口服或胃管注入,疗程为7 d。比较两组治疗前后中医证候评分、急性生理学与慢性健康状况Ⅱ(acute physiology and chronic health evaluation II,APACHEⅡ)量表评分、血清胰酶指标[淀粉酶(amylase,AMS)、脂肪酶(lipase,LPS)]、炎症指标[白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP)]、血清可溶性fms样酪氨酸激酶1(soluble fms like tyrosine kinase-1,sFlt-1)水平、血清α黑色素细胞刺激素(α-Melanocyte stimulating hormone,α-MSH)水平,并比较两组胃肠功能恢复时间和治疗总有效率。结果治疗后观察组中医证候评分、APACHEⅡ量表评分及血清AMS、LPS、IL-6、TNF-α、CRP、sFlt-1低于对照组(P<0.01),血清α-MSH水平高于对照组(P<0.01);观察组腹痛、腹胀消失时间、肠鸣音恢复时间和排气时间均少于对照组(P<0.01),治疗总有效率高于对照组(P<0.05)。结论胰炎消方可减轻炎症反应,缓解病情,改善血清sFlt-1、α-MSH水平,促进胃肠功能恢复,辅助治疗AP效果显著。

Objective To investigate the clinical efficacy of Yiyanxiao Formula in adjuvant treatment of acute pancreatitis(AP).Methods A total of 104 AP patients admitted to the Department of Critical Care Medicine of Qinhuangdao Hospital of Chinese Medicine from March 2021 to October 2022 were selected.The patients were assigned into observation and control groups respectively by the random number table method,with 52 cases in each group.The control group was treated with Western medicine,and the observation group was given Yiyanxiao Formula orally or gastric tube injection on the basis of Western medicine,and the course of treatment was 7 d.The TCM pattern score,acute physiology and chronic health evaluationⅡ(APACHEⅡ)scale score,serum pancreatic enzyme index[amylase(AMS),lipase(LPS)],inflammatory index[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and C-reactive protein(CRP)],and the levels of serum soluble fms-like tyrosine kinase 1(sFlt-1)and serumα-melanocyte-stimulating hormone(α-MSH)were compared between the two groups before and after treatment.In addition,the recovery time of gastrointestinal function and the total effective rate of treatment were compared between two groups.Results After treatment,the TCM pattern score,APACHEⅡscale score,and serum AMS,LPS,IL-6,TNF-α,CRP,and sFlt-1 of the observation group were lower than those of control group(P<0.01),and the serumα-MSH level was higher than that of control group(P<0.01).The disappearance time of abdominal pain and abdominal distension,recovery time of bowel sounds,and exhaust time of the observation group were shorter than those of control group(P<0.01).The total effective rate of treatment was higher than that of control group(P<0.05).Conclusion Yiyanxiao Formula can alleviate inflammatory response,relieve symptoms,improve serum sFlt-1 andα-MSH levels,promote gastrointestinal function recovery,which has a significant effect on the adjuvant treatment of AP.