龙胆泻肝汤加味治疗肝胆湿热型急性胰腺炎的研究

Study on the Modified Longdan Xiegan Decoction for the Treatment of acute Pancreatitis of Liver and Gallbladder Damp-heat Type

目的探讨龙胆泻肝汤加味治疗肝胆湿热型急性胰腺炎的临床效果。方法本研究为回顾性分析,将2020年1月至2021年6月柘城中医院收治的43例采用乌司他丁治疗的肝胆湿热型急性胰腺炎患者临床资料纳入对照组,将2021年7月至2022年12月本院收治的43例采用乌司他丁联合龙胆泻肝汤加味治疗的肝胆湿热型急性胰腺炎患者临床资料纳入观察组,两组均治疗4周。比较两组治疗前、治疗4周时中医证候评分、血清晚期糖基化终末产物受体(RAGE)、高迁移率族蛋白B1(HMGB1)及肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰基转移酶(γ-GGT)、总胆红素(TBIL)],并统计治疗期间临床相关指标及不良反应发生率。结果治疗4周时,两组各中医证候积分均低于治疗前,且观察组低于对照组;观察组腹痛和腹胀消失时间、肠鸣音恢复和住院时间均短于对照组;两组血清RAGE、HMGB1、ALT、AST、ALP、γ-GGT、TBIL水平均降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论肝胆湿热型急性胰腺炎患者采用龙胆泻肝汤加味治疗可显著减轻中医证候,改善RAGE、HMGB1水平及肝功能指标,且安全性较好。

Objective To explore the clinical effect of modified Longdan Xiegan decoction on the treatment of acute pancreatitis of liver and gallbladder damp-heat type.Methods This study is a retrospective analysis.The clinical data of 43 patients with acute pancreatitis of liver and gallbladder damp-heat type treated with ulinastatin from January 2020 to June 2021 at Zhecheng Traditional Chinese Medicine Hospital were included in the control group.The clinical data of 43 patients with liver and gallbladder dampness heat acute pancreatitis treated with ulinastatin combined with Longdan Xiegan decoction from July 2021 to December 2022 were included in the observation group,and both groups were treated for 4 weeks.The TCM syndrome scores,the receptor of advanced glycation end-products(RAGE),high mobility group protein B1(HMGB1),and liver function indicators[alanine aminotransferase(Alt),aspartate aminotransferase(AST),alkaline phosphatase(ALP),γ-glutamic acyltransferase(γ-GGT)and total bilirubin(TBIL)]between the two groups before treatment and at 4 weeks of treatment were compared,the related clinical indexes and the incidence of adverse reactions during the treatment were also analyzed.Results After 4 weeks of treatment,the TCM syndrome scores of both groups were lower than before treatment,and the observation group was lower than the control group;The disappearance time of abdominal pain and bloating,recovery of bowel sounds,and hospitalization time in the observation group were shorter than those in the control group;The levels of serum RAGE,HMGB1,ALT,AST,ALP,γ-GGT and TBIL between the two group were decreased,and the observation group was lower than the control group,with a statistically significant difference(P<0.05);There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The use of modified Longdan Xiegan decoction in the treatment of patients with acute pancreatitis of liver and gallbladder damp-heat type can significantly reduce traditional Chinese medicine symptoms,improve RAGE,HMGB1 levels,and liver function indicators,and has good safety.