自拟胰解通腑汤辅助治疗急性胰腺炎的效果及对血清内毒素的影响

Effect of self-made Yijie Tongfu Decoction in the auxiliary treatment of AP patients and its influence on serum endotoxin

目的:探讨中医自拟胰解通腑汤辅助西医疗法治疗急性胰腺炎(AP)患者的效果及对血清内毒素的影响。方法:选取我院收治的收治的87例AP患者作为研究对象,采用随机数字表分为联合组44例、对照组43例,两组患者均给予禁食、胃肠减压、抗感染、抗制胰酶活性等基础治疗措施,联合组患者加用自拟胰解通腑汤治疗(疗程2周);对比两组患者治疗前后的血清炎症因子、内毒素、血尿淀粉酶、临床症状缓解时间、临床疗效。结果:治疗前,联合组和对照组的IL-1β、IL-6、CRP、TNF-α、PCT水平差异无统计学意义(P>0.05);治疗2周后,联合组患者的血清IL-1β、IL-6、PCT均低于对照组(P<0.05);治疗前,联合组和对照组的血淀粉酶、尿淀粉酶、血清内毒素水平差异无统计学意义(P>0.05);治疗2周后,联合组患者的血淀粉酶、血清内毒素均低于对照组(P<0.05);治疗前,联合组和对照组的APACHEⅡ评分、MCTSI评分差异无统计学意义(P>0.05);治疗2周后,联合组患者的APACHEⅡ评分低于对照组(P<0.05);联合组患者的腹痛消失时间、腹胀消失时间、压痛消失时间、住院时间均低于对照组患者,差异具有统计学意义(P<0.05);联合组痊愈率34.09%、显效率47.73%、有效率15.91%、无效率2.27%,对照组的痊愈率20.93%、显效率41.86%、有效率30.23%、无效率6.98%(P<0.05);联合组整体上的治疗效果优于对照组(P<0.05)。结论:中医自拟胰解通腑汤辅助西医疗法治疗轻中度AP患者对于减轻炎症反应程度、降低内毒素水平、改善临床症状、提高临床效果方面有一定的作用。

Objective:To explore the effect of Chinese medicine self-made Yijie Tongfu Decoction in the treatment of acute pancreatitis(AP)patients with western medicine and its influence on serum endotoxin.Methods:A total of 87 AP patients admitted to our hospital were selected as the research objects.They were divided into 44 cases in the combined group and 43 cases in the control group using a random number table.Both groups were given fasting,gastrointestinal decompression,anti-infection,and anti-pancreatic therapy.Basic treatment measures such as enzyme activity,combined group patients were treated with selfmade Yijie Tongfu Decoction(2 weeks of treatment);serum inflammatory factors,endotoxin,blood urine amylase,clinical symptom relief time, clinical Efficacy. Results: Before treatment, there was no significant difference in the levels of IL-1β, IL-6, CRP, TNF-α, and PCT between the combination group and the control group (P>0. 05);after 2 weeks of treatment, the serumIL-1β, IL-6 and PCT were lower than those in the control group (P<0. 05);before treatment, there was no significantdifference in blood amylase, urine amylase, and serum endotoxin levels between the combination group and the control group (P>0. 05);treatment 2 Weeks later, the blood amylase and serum endotoxin of the combination group were lower than those of thecontrol group (P<0. 05);before treatment, there was no significant difference in APACHEⅡ and MCTSI scores between thecombination group and the control group (P>0. 05);After 2 weeks of treatment, the APACHE Ⅱ score of the combination groupwas lower than that of the control group (P<0. 05);the disappearance time of abdominal pain, abdominal distension, tendernessdisappearance time, and hospital stay of the combination group were lower than those of the control group, the difference was statisticallysignificant Significance (P<0. 05);the cure rate of the combined group was 34. 09%, the marked rate was 47. 73%,the effective rate was 15. 91%, and the inefficiency was 2. 27%. The cure rate of the control group was 20. 93%, the markedrate was 41. 86%, the effective rate was 30. 23%, and the inefficiency was 6. 98% (P<0. 05);the overall treatment effect ofthe combined group is better than the control group (P<0. 05). Conclusion: Chinese medicine self-made Yijie Tongfu Decoctionassisted with Western medical treatment for mild to moderate AP patients has a certain effect on reducing inflammation, reducingendotoxin levels, improving clinical symptoms, and improving clinical effects.