大柴胡汤联合生长抑素治疗急性胰腺炎的效果及对血清炎性指标、生化指标的影响

Effect of Dachaihu Decoction Combined with Somatostatin on Acute Pancreatitis and Its Impact on Serum Inflammatory and Biochemical Indicators

目的 探讨大柴胡汤联合生长抑素治疗急性胰腺炎(AP)患者效果及对血清炎性指标、生化指标等的影响。方法 选取2019年1月—2022年12月收治的AP 148例,按照治疗方法不同将其分为观察组和对照组2组各74例,观察组采用大柴胡汤联合生长抑素治疗,对照组采用生长抑素治疗。比较2组治疗后临床效果,治疗前后中医症状积分、血清炎性指标[降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、生化指标(血钙、血淀粉酶、尿淀粉酶)及外周血单核细胞p38丝裂原活化蛋白激酶(p38MAPK)、磷酸化-丝裂原活化蛋白激酶p38抗体(p-p38MAPK),以及治疗期间不良反应。结果 治疗后,观察组总有效率91.89%(68/74)高于对照组77.03%(57/74)(P<0.05)。治疗后,2组各中医症状积分、血清炎性指标、血淀粉酶、尿淀粉酶及外周血单核细胞p38MAPK、p-p38MAPK均低于治疗前;观察组血钙高于治疗前和对照组,各中医症状积分、血清炎性指标、血淀粉酶、尿淀粉酶及外周血单核细胞p38MAPK、p-p38MAPK低于对照组(P<0.01)。治疗期间,2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论 大柴胡汤联合生长抑素治疗AP患者效果显著,可减轻炎症反应,调节消化酶水平,下调外周血单核细胞p38MAPK、p-p38MAPK表达水平,进而改善临床症状。

Objective To investigate the effect of Dachaihu decoction combined with somatostatin in the treatment of acute pancreatitis(AP)and its effects on serum Serum inflammatory and biochemical indicators.Methods A total of 148 patients with AP treated from January 2019 to December 2022 were selected and divided into observation group(n=74)and control group(n=74)according to different treatment methods.The observation group was treated with Dachaihu decoction combined with somatostatin,while the control group was treated with somatostatin.The clinical effect after treatment was compared between the two groups.TCM symptom score,serum inflammatory indexes[procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],biochemical indexes(serum calcium,serum amylase,urine amylase)and expression levels of p38 mitogen-activated protein kinase(p38MAPK)and phosphoryl-mitogen-activated protein kinase p38 antibody(p-p38MAPK)in peripheral blood monocytes before and after treatment and adverse reactions during treatment were compared between the two groups.Results After treatment,the total effective rate of observation group was 91.89%(68/74),which was higher than that of control group[77.03%(57/74)](P<0.05).After treatment,the TCM symptom score,serum inflammatory indexes,blood amylase,urine amylase and p38MAPK and p-p38MAPK of peripheral blood mononuclear cells in the two groups were lower than those before treatment.The blood calcium of the observation group was higher than that before treatment,and that of the control group,and the TCM symptom score,serum inflammatory indexes,blood amylase,urine amylase and p38MAPK and P-P38MAPK of peripheral blood mononuclear cells were lower than those of the control group(P<0.01).There was no significant difference in total incidence of adverse reactions during treatment between the two groups(P>0.05).Conclusion Dachaihu decoction combined with somatostatin has a significant effect in the treatment of AP patients,which can reduce inflammatory reactions,regulate digestive enzyme levels,down-regulate p38MAPK and p-p38MAPK expression levels in peripheral blood mononuclear cells,and hence improve clinical symptoms.