柴芩承气汤加减联合针刺治疗重症急性胰腺炎临床研究

Clinical Study on Modified Bupleurum and Scutellaria Purgative Decoction Combined with Acupuncture in the Treatment of Severe Acute Pancreatitis

目的:观察柴芩承气汤加减联合针刺疗法对重症急性胰腺炎患者免疫功能、炎症反应和营养状况的影响。方法:将60例重症急性胰腺炎患者按照随机数字表法分为常规组和试验组,每组各30例。常规组给予柴芩承气汤加减治疗,试验组给予柴芩承气汤加减联合针刺治疗。比较两组患者治疗前后免疫功能指标、炎性因子水平[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)]、营养状态、中医证候积分及肠黏膜屏障功能指标的变化情况。结果:两组患者治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)低于本组治疗前,CD8^(+)高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后IL-6、TNF-α及CRP低于本组治疗前,且治疗后试验组低于常规组(P<0.05)。两组患者治疗后白蛋白及血红蛋白水平高于本组治疗前,且治疗后试验组高常规组(P<0.05)。两组患者治疗后中医证候积分低于本组治疗前,且治疗后试验组低于常规组(P<0.05)。两组患者治疗后D-乳酸、二胺氧化酶含量低于本组治疗前,且治疗后试验组低于常规组(P<0.05)。结论:柴芩承气汤加减联合针刺治疗重症急性胰腺炎患者,能改善患者临床症状,提高免疫功能及营养状态,降低炎性因子水平。

Objective:To observe the effect of Modified Bupleurum and Scutellaria Purgative Decoction combined with acupuncture on immune function,inflammatory response and nutritional status in patients with severe acute pancreatitis.Methods:A total of 60 patients with severe acute pancreatitis were divided into the conventional group and the experimental group according to the random number table method,with 30 cases in each group.The conventional group was treated with Modified Bupleurum and Scutellaria Purgative Decoction,while the experimental group was treated with Modified Bupleurum and Scutellaria Purgative Decoction combined with acupuncture.The changes in the immune function indexes,inflammatory factor levels [including interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C reactive protein(CRP)],nutritional status,TCM syndrome scores and intestinal mucosal barrier function indexes before and after treatment were compared between the two groups.Results:After treatment,the levels of CD3~+,CD4~+,CD4~+/CD8~+ in the two groups were lower than those before treatment,while CD8~+ was higher than that before treatment,and all the differences between the two groups were statistically significant(P<0.05);the levels of IL-6,TNF-α and CRP in the two groups were lower than those before treatment,and the above indexes in the experimental group were lower than those in the conventional group(P<0.05);the levels of albumin and hemoglobin in the two groups were higher than those before treatment,and the above indexes in the experimental group were higher than those in the conventional group(P<0.05);the syndrome scores of TCM in the two groups were lower than those before treatment,and the above indexes in the experimental group were lower than those in the conventional group(P<0.05);the contents of D-lactic acid and diamine oxidase in the two groups were lower than those before treatment,and the above indexes in the experimental group were lower than those in the conventional group(P<0.05).Conclusion:Modified Bupleurum and Scutellaria Purgative Decoction combined with acupuncture in the treatment of patients with severe acute pancreatitis can improve the clinical symptoms,enhance the immune function and nutritional status,and reduce the level of inflammatory factors.