中药灌肠联合常规西医治疗重症急性胰腺炎患者的效果

Effects of traditional Chinese medicine enema combined with conventional Western medicine in treatment of patients with severe acute pancreatitis

目的:观察中药灌肠联合常规西医治疗重症急性胰腺炎(SAP)患者的效果。方法:回顾性分析2021年1月至2023年8月该院收治的90例SAP患者的临床资料,根据治疗方法不同分为对照组、观察组各45例。对照组采用常规西医治疗,观察组在对照组基础上联合中药灌肠治疗,比较两组临床疗效、中医证候积分、多层螺旋CT(Balthazar CT)评分、急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、肠胃功能指标[内毒素(ET)、胃动素(MOT)、二胺氧化酶(DAO)]水平和血清炎性因子[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平。结果:观察组治疗总有效率为88.89%,明显高于对照组的71.11%,差异有统计学意义(P<0.05);治疗后,两组MOT水平高于治疗前,且观察组高于对照组,两组中医证候总积分、Balthazar CT评分、APACHEⅡ评分、DAO水平、ET水平以及血清TNF-α、CRP、IL-6水平低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论:中药灌肠联合常规西医治疗SAP患者可提高治疗总有效率,改善肠胃功能指标水平,降低中医证候总积分、Balthazar CT评分、APACHEⅡ评分以及血清炎性因子水平,效果优于单纯常规西医治疗。

Objective:To observe effects of traditional Chinese medicine enema combined with conventional Western medicine in treatment of patients with severe acute pancreatitis(SAP).Methods:The clinical data of 90 patients with SAP admitted to this hospital from January 2021 to August 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,45 cases in each group.The control group was treated with conventional Western medicine,while the observation group was treated with traditional Chinese medicine enema on the basis of that of the control group.The clinical efficacy,the TCM syndrome score,the multi-slice spiral CT(Balthazar CT)score,the acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,the gastrointestinal function index[endotoxin(ET),motilin(MOT),diamine oxidase(DAO)]levels,and the serum inflammatory factors[tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6)]levels were compared between the two groups.Results:The total effective rate of the observation group was 88.89%,which was significantly higher than that of the control group(71.11%),and the difference was statistically significant(P<0.05).After the treatment,the MOT levels of the two groups were higher than those before the treatment,and that in the observation group was higher than the that in control group;the total scores of TCM syndromes,the Balthazar CT scores,the APACHEⅡscores,the DAO levels,the ET levels and the serum TNF-α,CRP and IL-6 levels in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group;and the differences were statistically significant(P<0.05).Conclusions:Traditional Chinese medicine enema combined with conventional Western medicine in the treatment of the patients with SAP can improve the total effective rate of treatment,improve the levels of gastrointestinal function indexes and reduce the total scores of TCM syndromes,the Balthazar CT scores,the APACHEⅡscores and the serum inflammatory factor levels.Moreover,it is superior to simple conventional western medicine treatment.