通腑解毒汤联合乌司他丁治疗重症急性胰腺炎患者的效果

Effects of Tongfu Jiedu decoction combined with Ulinastatin in treatment of patients with severe acute pancreatitis

目的:观察通腑解毒汤联合乌司他丁治疗重症急性胰腺炎(SAP)患者的效果。方法:选取2021年1月至2023年1月该院收治的78例SAP患者进行前瞻性研究,根据随机数字表法将其分为观察组和对照组各39例。对照组予以乌司他丁治疗,观察组在对照组基础上联合通腑解毒汤治疗,比较两组临床疗效、临床症状改善时间、住院时间,治疗前后实验室指标[血淀粉酶(AMS)、尿淀粉酶(UAMY)、脂肪酶(LPS)、超氧化物歧化酶(SOD)]水平、炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平和疼痛程度[视觉模拟评分表(VAS)]评分。结果:观察组治疗总有效率为94.87%(37/39),高于对照组的76.92%(30/39),差异有统计学意义(P<0.05);观察组腹痛腹胀缓解时间、肠鸣音恢复时间、首次排便时间和住院时间均短于对照组,差异有统计学意义(P<0.05);治疗后,观察组AMS、UAMY、LPS水平均低于对照组,SOD水平高于对照组,差异有统计学意义(P<0.05);治疗后,观察组CRP、TNF-α、IL-6水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。结论:通腑解毒汤联合乌司他丁治疗SAP患者可提高治疗总有效率,缩短临床症状改善时间和住院时间,改善实验室指标水平,降低炎性因子水平和VAS评分,效果优于单纯乌司他丁治疗。

Objective:To observe effects of Tongfu Jiedu decoction combined with Ulinastatin in treatment of patients with severe acute pancreatitis(SAP).Methods:A prospective study was conducted on 78 patients with SAP admitted to the hospital from January 2021 to January 2023.According to the random number table method,they were divided into observation group and control group,39 cases in each group.The control group was treated with Ulinastatin,while the observation group was treated with Tongfu Jiedu decoction on the basis of that of the control group.The clinical efficacy,the clinical symptom improvement time,the hospitalization time,the laboratory indexes[blood amylase(AMS),urine amylase(UAMY),lipase(LPS),superoxide dismutase(SOD)]levels,the inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]levels,and the pain degree[visual analogue scale(VAS)]scores were compared between the two groups before and after the treatment.Results:The total effective rate of the observation group was 94.87%(37/39),which was higher than 76.92%(30/39)of the control group,and the difference was statistically significant(P<0.05).The remission time of abdominal pain and distension,the recovery time of bowel sounds,the first defecation time and the hospitalization time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of AMS,UAMY and LPS in the observation group were lower than those in the control group,the level of SOD was higher than that in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of CRP,TNF-αand IL-6 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,after the treatment,the VAS score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusions:Tongfu Jiedu decoction combined with Ulinastatin in the treatment of the SAP patients can improve the total effective rate of treatment,shorten the clinical symptom improvement time and the hospitalization time,improve the levels of laboratory indexes,and reduce the levels of inflammatory factors and the VAS score.Moreover,it is superior to simple Ulinastatin treatment.