通腑泄热方与大黄芒硝散联合常规疗法治疗急性胰腺炎肝胆湿热证临床研究

Clinical Study on Tongfu Xiere Prescription and Dahuang Mangxiao Powder Combined with Conventional Therapy for Acute Pancreatitis with Liver-Gallbladder Damp-Heat Syndrome

目的:观察在常规疗法基础上加用通腑泄热方联合大黄芒硝散治疗急性胰腺炎肝胆湿热证的临床疗效。方法:将纳入研究的98例急性胰腺炎肝胆湿热证患者随机分为联合组和西医组各49例,西医组接受常规疗法治疗,联合组在常规疗法基础上加用通腑泄热方内服联合大黄芒硝散贴敷神阙穴治疗。2组均治疗7 d。观察2组患者的腹痛消失时间、腹胀消失时间、体温恢复正常时间、肠鸣音恢复时间;治疗前、治疗7 d后分别评定2组患者的中医证候评分,检测炎症因子[白细胞介素(IL)-6、肿瘤坏死因子-α (TNF-α)、C-反应蛋白(CRP)]和血清淀粉酶(AMS)水平。比较2组的临床疗效。结果:治疗后,联合组总有效率高于西医组(P<0.05)。联合组腹痛消失时间、腹胀消失时间、体温恢复正常时间、肠鸣音恢复时间均短于西医组(P<0.05)。2组脘腹胀痛、大便黏滞、身目发黄、烦渴引饮、胸闷不舒、小便短赤评分均较治疗前降低(P<0.05)。联合组6项证候评分均低于西医组(P<0.05)。2组TNF-α、IL-6、CRP、AMS水平均较治疗前下降(P<0.05)。联合组TNF-α、IL-6、CRP、AMS水平均低于西医组(P<0.05)。结论:在常规疗法基础上加用通腑泄热方内服联合大黄芒硝散贴敷神阙穴治疗急性胰腺炎肝胆湿热证效果显著,可提高疗效,更好地减轻症状和炎症反应。

Objective:To observe the clinical effect of Tongfu Xiere Prescription and Dahuang Mangxiao Powder combined with conventional therapy on acute pancreatitis with liver-gallbladder damp-heat syndrome.Methods:A total of 98 cases of patients who had acute pancreatitis with liver-gallbladder damp-heat syndrome were enrolled in the study and randomly divided into the combination group and the western medicine group,with 49 cases in each group.The western medicine group received conventional therapy,and the combination group was additionally treated with the oral administration of Tongfu Xiere Prescription and the external application with Dahuang Mangxiao Powder at Shenque(RN8)point based on conventional therapy.Both groups were treated for seven days.The disappearance time of abdominal pain and distention,the time for body temperature to return to normal,and the recovery time of bowel sounds were observed in the two groups.Before treatment and after seven-day treatment,traditional Chinese medicine(TCM)syndrome scores were evaluated in the two groups and the levels of inflammatory factors[interleukin(IL)-6 and tumor necrosis factor-α(TNF-α),and C-reactive protein(CRP)]and serum amylase(AMS)were measured.Clinical effects were compared between the two groups.Results:After treatment,the total effective rate in the combination group was higher than that in the western medicine group(P<0.05).The disappearance time of abdominal pain and distention,the time for body temperature to return to normal,and the recovery time of bowel sounds in the combination group were shorter than those in the western medicine group(P<0.05).The scores of abdominal distention and pain,sticky stool,yellow body and eyes,polydipsia,chest oppression,and dark urine with a low output in the two groups were declined when compared with those before treatment(P<0.05);the six TCM syndrome scores in the combination group were lower than those in the western medicine group(P<0.05).The levels of TNF-α,IL-6,CRP,and AMS in the two groups were decreased when compared with those before treatment(P<0.05);the levels of TNF-α,IL-6,CRP,and AMS in the combination group were lower than those in the western medicine group(P<0.05).Conclusion:Tongfu Xiere Prescription and Dahuang Mangxiao Powder combined with conventional therapy has a significant effect on the treatment of acute pancreatitis with liver-gallbladder damp-heat syndrome,which can enhance curative effects and better relieve symptoms and inflammatory reactions.