Network Pharmacology Research of Qingyi Decoction(清胰汤)in the Treatment of Acute Pancreatitis

Presently,clinically specific drugs are absent for acute pancreatitis(AP).Numerous clinical investigations have extolled the notable efficacy of Qingyi Decoction(QYD,清胰汤)in the management of AP.However,the molecular mechanisms are lacking.Therefore,we analyzed pharmacological mechanisms of QYD in treating AP through network pharmacology.As for the network pharmacology,173active compounds and 1,073 active target genes for QYD were identified.Of these,884 active target genes correlated with AP among the 11128 AP-associated genes and were linked to the 173 active compounds.In addition,GO functional enrichment and KEGG pathway enrichment revealed that these target genes were mainly enriched in cancer signaling,neuroactive ligand-receptor interactions,lipids and atherosclerosis,cAMP signaling,central carbon metabolism in cancer,and calcium signaling pathways.Finally,molecular docking was employed to assess the binding affinity between target proteins and their associated compounds.This study identified critical compounds and potential target genes.Our study may serve as a foundation for subsequent investigations on the therapeutic potential of QYD in treating AP.

Therapeutic effect of Qingyi decoction in severe acute pancreatitis-induced intestinal barrier injury

AIM: To investigate the effect of Qingyi decoction onthe expression of secreted phospholipase A2(s PLA2) in intestinal barrier injury.METHODS: Fifty healthy Sprague-Dawley rats were randomly divided into control, severe acute pancreatitis(SAP), Qingyi decoction-treated(QYT), dexamethasonetreated(DEX), and verapamil-treated(VER) groups. The SAP model was induced by retrograde infusion of 1.5% sodium deoxycholate into the biliopancreatic duct of the rats. All rats were sacrificed 24 h post-SAP induction. Arterial blood, intestine, and pancreas from each rat were harvested for investigations. The levels of serum amylase(AMY) and diamine oxidase(DAO) were determined using biochemical methods, and serum tumor necrosis factor(TNF)-α level was measured by an enzyme linked immunosorbent assay. Pathologic changes in the harvested tissues were investigated by microscopic examination of hematoxylin and eosinstained tissue sections. The expressions of s PLA2 at m RNA and protein levels were detected by reverse transcriptase PCR and Western blot, respectively. A terminal deoxynucleotidyl transferase-mediated d UTP nick-end labeling assay was used to investigate apoptosis of epithelial cells in the intestinal tissues. RESULTS: Compared to the control group, the expression of s PLA2 at both the m RNA and protein levels increased significantly in the SAP group(0.36 ± 0.13 vs 0.90 ± 0.38, and 0.16 ± 0.05 vs 0.64 ± 0.05, respectively; P s < 0.01). The levels of AMY, TNF-α and DAO in serum were also significantly increased(917 ± 62 U/L vs 6870 ± 810 U/L, 59.7 ± 14.3 ng/L vs 180.5 ± 20.1 ng/L, and 10.37 ± 2.44 U/L vs 37.89 ± 5.86 U/L, respectively; P s < 0.01). The apoptosis index of intestinal epithelial cells also differed significantly between the SAP and control rats(0.05 ± 0.02 vs 0.26 ± 0.06; P < 0.01). The serum levels of DAO and TNF-α, and the intestinal apoptosis index significantly correlated with s PLA2 expression in the intestine(r = 0.895, 0.893 and 0.926, respectively; Ps < 0.05). Thelevels of s PLA2, AMY, TNF-α, and DAO in the QYT, VER, and DEX groups were all decreased compared with the SAP group, but not the control group. Qingyi decoction intervention, however, gave the most therapeutic effect against intestinal barrier damage, although the onset of its therapeutic effect was slower. CONCLUSION: Qingyi decoction ameliorates acute pancreatitis-induced intestinal barrier injury by inhibiting the overexpression of intestinal s PLA2. This mechanism may be similar to that of verapamil.

Qingyi decoction protects against myocardial injuries induced by severe acute pancreatitis

BACKGROUND We studied the protective effects of Qingyi decoction(QYD)(a Traditional Chinese Medicine)against severe acute pancreatitis(SAP)-induced myocardial infarction(MI).AIM To study the function and mechanism of QYD in the treatment of myocardial injuries induced by SAP.METHODS Ultrasonic cardiography,hematoxylin and eosin staining,immunohistochemistry,qRT-PCR,western blot,enzyme-linked immunosorbent assays,and apoptosis staining techniques were used to determine the effects of QYD following SAP-induced MI in Sprague-Dawley rats.RESULTS Our SAP model showed severe myocardial histological abnormalities and marked differences in the symptoms,mortality rate,and ultrasonic cardiography outputs among the different groups compared to the control.The expression of serum cytokines[interleukin(IL)-1?,IL-6,IL-8,IL-12,amyloidβ,and tumor necrosis factor-α]were significantly higher in the SAP versus QYD treated group(P<0.05 for all).STIM1 and Orai1 expression in myocardial tissue extracts were significantly decreased post QYD gavage(P<0.001).There was no significant histological difference between the 2-aminoethyl diphenylborinate inhibitor and QYD groups.The SAP group had a significantly higher apoptosis index score compared to the QYD group(P<0.001).CONCLUSION QYD conferred cardio-protection against SAP-induced MI by regulating myocardial-associated protein expression(STIM1 and Orai1).

Qingyi decoction attenuates intestinal epithelial cell injury via the calcineurin/nuclear factor of activated T-cells pathway

BACKGROUND Recent studies have demonstrated that dysfunction of the intestinal barrier is a significant contributing factor to the development of severe acute pancreatitis(SAP).A stable intestinal mucosa barrier functions as a major anatomic and functional barrier,owing to the balance between intestinal epithelial cell(IEC)proliferation and apoptosis.There is some evidence that calcium overload may trigger IEC apoptosis and that calcineurin(CaN)/nuclear factor of activated Tcells(NFAT)signaling might play an important role in calcium-mediated apoptosis.AIM To investigate the potential mechanisms underlying the therapeutic effect of Qingyi decoction(QYD)in SAP.METHODS A rat model of SAP was created via retrograde infusion of sodium deoxycholate.Serum levels of amylase,tumor necrosis factor(TNF-α),interleukin(IL)-6,D-lactic acid,and diamine oxidase(DAO);histological changes;and apoptosis of IECs were examined in rats with or without QYD treatment.The expression of the two subunits of CaN and NFAT in intestinal tissue was measured via quantitative realtime polymerase chain reaction and western blotting.For in vitro studies,Caco-2 cells were treated with lipopolysaccharide(LPS)and QYD serum,and then cell viability and intracellular calcium levels were detected.RESULTS Retrograde infusion of sodium deoxycholate increased the severity of pancreatic and intestinal pathology and the levels of serum amylase,TNF-α,and IL-6.Both the indicators of intestinal mucosa damage(D-lactic acid and DAO)and the levels of IEC apoptosis were elevated in the SAP group.QYD treatment reduced the serum levels of amylase,TNF-α,IL-6,D-lactic acid,and DAO and attenuated the histological findings.IEC apoptosis associated with SAP was ameliorated under QYD treatment.In addition,the protein expression levels of the two subunits of CaN were remarkably elevated in the SAP group,and the NFATc3 gene was significantly upregulated at both the transcript and protein levels in the SAP group compared with the control group.QYD significantly restrained CaN and NFATc3 gene expression in the intestine,which was upregulated in the SAP group.Furthermore,QYD serum significantly decreased the LPS-induced elevation in intracellular free Ca^(2+)levels and inhibited cell death.CONCLUSION QYD can exert protective effects against intestinal mucosa damage caused by SAP and the protective effects are mediated,at least partially,by restraining IEC apoptosis via the CaN/NFATc3 pathway.

Analysis of Clinical Effect of Wumen Qingyi Decoction on Acute Pancreatitis

[Objectives]To examine the effects of Wumen Qingyi Decoction on inflammatory responses in patients with acute pancreatitis(AP).[Methods]Eighty patients with mild or severe AP were randomly allocated to a treatment group(Wumen Qingyi Decoction+baseline treated)or a control group(baseline treated).All patients were managed conservatively.In addition,the Group A received Wumen Qingyi Decoction for 400 mL/d for 7 d.Laboratory parameters,condition of disease and therapeutic effect indexes,and so on,between the two groups were compared.[Results]The recovery of serum levels of amylase(AMS),C reaction protein(CRP),and tumor necrosis factor(TNF-α),interleukin1(IL-1),IL-6,IL-10,as well as the scores of Balthazar and BISAP in Treatment group were quicker than those in Control group(P<0.05).In addition,the improvement of organic dysfunction in Treatment group was better than that in Control group.[Conclusions]The course of combined Wumen Qingyi Decoction and basic treatment of western medicine could effectively adjust the body's inflammatory response to promote the recovery process of acute pancreatitis.

Protecting Women's Rights and Interests,Promoting Human Rights of All——An interview with Huang Qingyi, Vice-Chairperson of All-China Women's Federation

Women's human rights are an important component part of human rights. The Chinese government has over the years made equality between men and women a basic state policy and made achievements that have attracted worldwide attention in the legislation and practice on protecting the rights of women. Not long ago, Ms. Huang Qingyi, Vice-Chairperson of the All-China Women's Federation, granted an interview with this reporter and answered questions on related issues.

Research Progress of Qingyi Decoction(清胰汤)in Treating Acute Pancreatitis

Acute pancreatitis(AP)is one of the most common digestive system diseases.AP is associated with high rate of hospitalization and death risk,but it lacks specific and effective therapies.Qingyi Decoction(清胰汤)is the basic formula for AP treatment.Qingyi Decoction can improve symptoms,inhibit inflammatory,ameliorate AP-induced organ injury via multiple pathways and targets,as demonstrated in many preclinical and clinical studies.This review summarized the progress of the clinical studies and mechanisms of Qingyi Decoction,aimed to provide valuable research information for the future clinical application and molecular mechanism research of Qingyi decoction.

中药熏蒸联合清胰汤加减治疗轻症急性胰腺炎的随机对照研究

目的:观察中药熏蒸联合清胰汤加减内服治疗轻症急性胰腺炎的临床疗效。方法:选择100例轻症急性胰腺炎患者为研究对象,按随机数字表法分为观察组和对照组各50例。对照组给予奥曲肽治疗,观察组在对照组治疗基础上给予中药熏蒸及清胰汤内服治疗,两组均连续治疗14天。观察两组治疗前后中医证候积分、血清炎症因子、血清淀粉酶、全身炎症反应综合征评分、急性胰腺炎严重程度指标评分的变化情况,以及临床症状消失时间、临床疗效及安全性。结果:治疗后,两组中医证候积分均低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。治疗后,两组血清炎症因子、血清淀粉酶水平、全身炎症反应综合征评分、急性胰腺炎严重程度指标评分均较治疗前下降(P<0.05),且观察组均低于对照组(P<0.05)。观察组临床症状消失时间均明显短于对照组(P<0.05);观察组总有效率[98.00%(49/50)]高于对照组[84.00%(42/50)](P<0.05);两组在治疗过程中均未发生不良反应。结论:采用中药熏蒸联合加减清胰汤内服治疗轻症急性胰腺炎,能够明显减轻患者临床症状,缩短病程,降低患者血清炎性因子、AMS等实验室指标,并提升临床疗效。

任氏清胰汤治疗轻中度急性胰腺炎的临床效果

目的探讨任氏清胰汤治疗轻中度急性胰腺炎的临床效果。方法选取2020年1月至2021年12月苏州市中医医院收治的40例轻度及中度急性胰腺炎患者作为研究对象,按照随机数字表法将其分为治疗组(20例)及对照组(20例),治疗组采取常规西医综合治疗,对照组采取常规西医治疗联合任氏清胰汤治疗,比较两组临床综合疗效、中医证候评分、腹痛疼痛数字评分法(NRS)评分、腹胀视觉模拟评分法(VAS)评分、首次进食时间、首次排便/排气时间、肠鸣音恢复时间、淀粉酶(AMS)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、急性胰腺炎严重程度床边指数(BISAP)评分。结果治疗后,治疗组的总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,治疗组的首次进食时间、首次排便/排气时间、肠鸣音恢复时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,治疗组的中医证候积分、腹痛NRS评分、腹胀VAS评分、BISAP评分均低于对照组,差异有统计学意义(P<0.05)。治疗组治疗3、5、7 d的AMS、CRP、TNF-α均低于对照组,差异有统计学意义(P<0.05);治疗组治疗3、5、7 d的IL-10均高于对照组,差异有统计学意义(P<0.05);两组治疗3、5、7 d的IL-1及IL-6比较,差异无统计学意义(P>0.05)。结论任氏清胰汤联合西药治疗急性胰腺炎的疗效确切,可改善临床症状,缓解炎症反应程度,药物安全性良好。

清胰汤对肝缺血再灌注损伤小鼠的肝脏保护作用及铁死亡机制研究

目的 观察清胰汤对肝缺血再灌注损伤小鼠肝脏的保护作用并探讨其机制。方法 30只雄性SPF级C57BL/6小鼠随机分为5组:假手术组、模型组及清胰汤低、中、高剂量组,每组6只。各清胰汤组小鼠于造模前7 d连续灌胃相应剂量药物,假手术组及模型组小鼠灌胃生理盐水。以夹闭小鼠肝左叶及肝中叶动静脉血流的方法构建70%肝脏缺血再灌注损伤模型,缺血60 min,再灌注12 h。以ELISA法检测血清肝酶指标;HE染色观察肝组织缺血情况;DHE荧光探针观察肝细胞活性氧(ROS)水平;酶标仪检测肝组织亚铁离子含量及脂质过氧化水平(MDA);Western blotting法及免疫组化染色检测肝组织GPX4表达情况。结果 清胰汤中、高剂量均可以明显改善小鼠肝缺血再灌注损伤,有效降低小鼠血清谷丙转氨酶(ALT)、谷草转氨酶(AST)水平(P<0.05),减少肝组织缺血坏死情况,降低肝细胞ROS水平,并且能够有效降低肝组织亚铁离子含量及脂质过氧化水平(P<0.05),恢复GPX4活性(P<0.05)。结论 清胰汤中、高剂量均可减轻模型小鼠的肝脏氧化应激,减少肝缺血坏死,改善肝功能,对于肝缺血再灌注损伤的肝脏具有保护作用,其潜在机制可能与干预肝铁死亡的发生有关,且其作用呈剂量依赖性。

Babaodan Capsule(八宝丹胶囊)Combined with Qingyi Huaji Formula(清胰化积方)in Advanced Pancreatic Cancer--A Feasibility Study

Objective: To observe the clinical effects of Babaodan Capsule(八宝丹, BBD) combined with Qingyi Huaji Formula(清胰化积方, QYHJ) in treating patients with advanced pancreatic cancer. Methods: Eighty-one patients with advanced pancreatic cancer(from January 1, 2013 to December 31, 2014) were enrolled. Patients were assigned to two groups: QYHJ plus BBD group(40 cases) and QYHJ only group(41 cases), and there were no significant differences for other treatment between two groups. The survival and cancer-related symptoms were compared between two groups over two cycles of treatment. Results: The cancer-related symptoms of patients such as ascites, jaundice, pain, abdominal distension, anorexia and Karnofsky performance status of QYHJ plus BBD group were significantly improved as compared with those of the QYHJ group(P<0.01). In addition, the 1-year survival rate of patients in QYHJ plus BBD group was longer than that in the QYHJ group(65% vs. 33%, respectively, P=0.0023). Conclusions: BBD with QYHJ is feasible treatment to prolong the survival of patients with advanced pancreatic cancer. However, it deserves to be further investigated in randomized clinical trials.

清潩河流域水污染物排放标准实施评估

污染物排放标准评估是排放标准执行周期中的重要环节,但中国对流域型水污染物排放标准实施效果评估的实践探索较缺乏。在现有规范指南的基础上,针对《清潩河流域水污染物排放标准》(DB 41/790—2013)构建了适用于清潩河流域特点的水污染物排放标准评估体系,并在清潩河流域对该标准实施情况进行了评估。结果表明,该标准对重点污染物控制处于中等水平,在分区域精细控制方面略有欠缺,该标准实施实现了流域内污染源排放方式优化,促进了污染物排放量的削减、产业结构优化、落后产能淘汰;该标准实施后流域水环境得到较大改善,但也存在对行业排污控制针对性、约束性不足等问题。

通腑清胰汤治疗湿热壅滞证重症胰腺炎患者的效果观察

目的:探讨通腑清胰汤治疗湿热壅滞证重症胰腺炎(SAP)患者的效果。方法:将2019年3月—2022年2月在南昌市第一医院接受诊治的92例SAP患者纳入研究,按照随机数字表法将患者分为研究组和对照组,各46例。对照组接受SAP综合治疗,研究组在对照组基础上经胃管灌注通腑清胰汤。比较两组临床疗效、T淋巴细胞(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、胃肠动力指标[胃动素(MTL)、血管活性肠肽(VIP)、胆囊收缩素(CCK)]。结果:入组92例SAP患者,治疗期间研究组剔除3例,对照组剔除2例,最终研究组43例,对照组44例完成研究。两组治疗后CD4^(+)、CD4^(+)/CD8^(+)相较于治疗前均升高,CD8^(+)相较于治疗前均降低,研究组CD4^(+)、CD4^(+)/CD8^(+)均高于对照组,CD8^(+)低于对照组,差异均有统计学意义(P<0.05)。两组治疗后MTL、CCK相较于治疗前均升高,VIP相较于治疗前均降低,研究组MTL、CCK均高于对照组,VIP低于对照组,差异均有统计学意义(P<0.05)。两组治疗总有效率比较,差异无统计学意义(P>0.05);研究组临床痊愈率^(+)显效率高于对照组,差异有统计学意义(P<0.05)。结论:使用通腑清胰汤联合SAP综合治疗方案能够显著改善湿热壅滞证SAP患者T淋巴细胞亚群,调节免疫功能,还能够提高胃肠动力,有助于促进疾病缓解。

清胰汤联合冰硝散外敷在急性胰腺炎胰周积液中的应用

目的探讨清胰汤联合冰硝散外敷在急性胰腺炎胰周积液中的应用价值。方法选择2021年1月至2023年2月日照市中医医院收治的80例急性胰腺炎并发胰周积液患者为研究对象。按照随机数字表法分为观察组及对照组,各40例。对照组应用清胰汤口服,观察组则在口服清胰汤的基础上联合冰硝散经皮外敷。比较两组的腹痛、腹胀、肠鸣音恢复正常时间,比较两组血淀粉酶恢复正常时间和胰周积液吸收50%以上时间,观察两组治疗过程中C反应蛋白水平变化,统计两组的并发症总发生率及住院时间。结果观察组的腹痛、腹胀及肠鸣音恢复正常时间短于对照组,差异有统计学意义(P<0.05),观察组的血淀粉酶恢复正常时间和胰周积液吸收50%以上时间短于对照组,差异有统计学意义(P<0.05),两组患者治疗3、7 d时的C反应蛋白水平均低于治疗前,治疗7 d时的C反应蛋白水平低于治疗3 d时,差异有统计学意义(P<0.05),且观察组治疗3、7 d时的C反应蛋白水平均低于对照组同期,差异有统计学意义(P<0.05),观察组的并发症等总发生率低于对照组,差异有统计学意义(P<0.05)。结论针对急性胰腺炎胰周积液,清胰汤灌肠或口服联合冰硝散外敷,可促进胃肠道功能恢复,促进积液吸收,抑制机体炎症,减少胰腺炎相关并发症,缩短住院时间。

清胰通腑汤保留灌肠联合常规西药治疗急性胰腺炎合并麻痹性肠梗阻患者的效果

目的:探讨清胰通腑汤保留灌肠联合常规西药治疗急性胰腺炎(AP)合并麻痹性肠梗阻(PI)患者的效果。方法:选取2021年3月至2023年1月该院收治的78例AP合并PI患者进行前瞻性研究,按照随机数字表法分为观察组和对照组各39例。两组均予以禁食、禁水、胃肠减压、静脉注射奥曲肽等常规治疗,在此基础上观察组采用清胰通腑汤行保留灌肠,对照组采用生理盐水行不保留灌肠。比较两组临床疗效、康复时间、血清炎性因子[C反应蛋白(CRP)、降钙素原(PCT)]水平、胰腺功能指标[血清淀粉酶、转化生长因子-β1(TGF-β1)]水平及不良反应发生率。结果:观察组治疗总有效率为94.87%(37/39),高于对照组的79.49%(31/39),差异有统计学意义(P<0.05);观察组首次排气时间、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,观察组血清CRP、PCT、淀粉酶水平均低于对照组,TGF-β1水平高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:清胰通腑汤保留灌肠联合常规西药治疗AP合并PI患者效果显著,能加快症状缓解,缩短住院时间,降低血清淀粉酶及炎性因子水平,促进胰腺修复,提高TGF-β1水平,效果优于单纯西药治疗。

外敷冰硝散联合口服清胰汤治疗急性胰腺炎临床观察

目的观察冰硝散外敷加清胰汤口服联合常规西药治疗急性胰腺炎的临床疗效。方法将文山州中医医院2020年1月—2022年1月收治的63例急性胰腺炎患者按照随机数字表法分为对照组(31例)和试验组(32例)。对照组给予常规西药治疗,试验组在对照组治疗的基础上加用冰硝散外敷联合清胰汤口服治疗。比较治疗前后2组患者的中医证候积分、通便时间、肠道功能评分及临床疗效。结果治疗后,试验组中医证候积分、通便时间及胃肠道功能评分均低于对照组(P<0.05),总有效率高于对照组(P<0.05)。结论冰硝散外敷加清胰汤口服联合常规西药治疗急性胰腺炎,能改善患者胃肠道功能、中医证候学积分,疗效显著。

柴黄清胰活血颗粒对雨蛙素诱导的大鼠胰腺腺泡细胞损伤的保护作用及机制

目的观察柴黄清胰活血颗粒对雨蛙素(caerulein)诱导的大鼠胰腺腺泡细胞损伤的保护作用,并探讨柴黄清胰活血颗粒对JAK2/STAT3信号通路的调控机制。方法取对数生长期的AR42J细胞,通过CCK-8法检测不同浓度柴黄清胰活血颗粒对AR42J细胞活性的影响并筛选最佳药物干预浓度;用雨蛙素刺激细胞6 h构建胰腺炎体外模型;随机分为空白对照组、模型组、柴黄清胰活血颗粒低、中、高剂量组(0.5、1、2 mg/mL);ELISA法测定细胞上清液中TNF-α、IL-6、IL-1β的表达;实时荧光定量PCR测定各组细胞JAK2、STAT3基因表达水平;Western blot法检测各组细胞JAK2、STAT3、p-JAK2、p-STAT3蛋白表达水平。结果CCK-8法检测发现,当药物浓度为0.5、1及2 mg/mL时,平均细胞存活率均大于100%;ELISA检测发现,与空白组相比,模型组炎性细胞因子IL-6、IL-8、TNF-α升高,提示AR42J细胞急性胰腺炎模型的成功建立;与模型组相比,柴黄清胰活血颗粒组(0.5、1、2 mg/mL)IL-6、IL-1β、TNF-α明显降低,差异具有统计学意义(P<0.05);实时荧光定量PCR检测发现,与模型组相比,柴黄清胰活血颗粒组(0.5、1、2 mg/mL)STAT3 mRNA、柴黄清胰活血颗粒组(2 mg/mL)JAK2 mRNA表达水平显著下降(P<0.05);westen blot测定发现,与模型组相比,柴黄清胰活血颗粒组(0.5、1、2 mg/mL)p-JAK2/JAK2、p-STAT3/STAT3蛋白相对表达量显著下降(P<0.05)。结论柴黄清胰活血颗粒可能通过调控JAK2/STAT3信号通路中关键分子表达,从而减轻AR42J细胞炎症反应。

清胰汤联合结肠途径治疗仪对重症急性胰腺炎患者胰腺功能及炎性因子的影响

目的探讨清胰汤联合结肠途径治疗仪对重症急性胰腺炎患者胰腺功能及炎性因子的影响。方法选择2021年1月至2022年12月医院住院治疗的116例重症急性胰腺炎患者,采用随机数字表法分为对照组和观察组,每组58例。对照组应用结肠途径治疗仪联合大黄浓煎液治疗,观察组应用结肠途径治疗仪联合清胰汤治疗。比较两组的临床效果、中医证候评分、乳酸水平及胰腺功能、炎性因子、不良反应。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05);观察组中医证候评分低于对照组,差异有统计学意义(P<0.05);观察组乳酸水平低于对照组,差异有统计学意义(P<0.05);观察组胰岛素(INS)高于对照组,差异有统计学意义(P<0.05),葡萄糖(GLU)、血淀粉酶(AMY)、胰蛋白酶原-2(TPS2)低于对照组,差异有统计学意义(P<0.05);治疗后,观察组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)低于对照组,差异有统计学意义(P<0.05);两组不良反应比较,差异无统计学意义(P>0.05)。结论清胰汤联合结肠途径治疗仪可改善重症急性胰腺炎患者的胰腺功能,促使肠黏膜屏障功能恢复,减轻机体的炎性反应,改善临床症状。

清胰汤辅助治疗重症急性胰腺炎临床疗效及安全性观察

目的:探究清胰汤辅助治疗重症急性胰腺炎患者的临床疗效及安全性。方法:选取2020年7月至2022年7月本院收治的重症急性胰腺炎患者76例作为研究对象。随机将患者分为研究组与对照组,每组各38例。对照组采取乌司他丁等治疗;研究组采取清胰汤辅助乌司他丁治疗,两组均治疗14 d后进行数据观察,对比两组的临床疗效、中医症候积分、胰腺功能改善时间、胃肠功能恢复情况及不良反应。结果:研究组的治疗总有效率显著高于对照组(P<0.05)。治疗前,两组的腹痛剧烈、胸闷腹胀、恶心呕吐及便溏不爽等中医症候积分均无显著差异。治疗后两组的中医症候积分均下降,且研究组的中医症候积分均显著低于对照组(P<0.05),研究组的尿淀粉酶恢复正常时间与血淀粉酶恢复正常时间均比对照组显著缩短(P<0.05)。研究组腹痛消失时间、发热消失时间、肠鸣音恢复时间与腹胀消失时间均比对照组显著缩短(P<0.05)。研究组不良反应率比对照组显著降低(P<0.05)。结论:清胰汤辅助治疗重症急性胰腺炎可提高疗效,改善临床症状,促进胰腺功能及胃肠功能恢复,减少不良反应。

Synergetic Effect of Yihuo Qingyi Decoction (益活凊胰汤) and Recombinant Staphylokinase in Treatment of Severe Acute Pancreatitis of Rats

Objective: To investigate the effect of recombinant staphylokinase (r-Sak) and the Chinese medicine Yihuo Qingyi Decoction (益活凊胰汤 Herbal decoction for severe acute pancreatitis) in the treatment of the severe acute pancreatitis (SAP) in rats, and to observe the synergistic effect of the two. Methods: One hundred and sixty-two adult male SD rats with the body mass of 250–280 g were randomly divided into the following 5 groups: sham operation group (n=18), control group (n=36), Yihuo Qingyi Decoction treatment group (n=36), r-Sak treatment group (n=36), and Yihuo Qingyi Decoction plus r-Sak treatment group (n=36). The SAP ratmodel was prepared by retrograde injection of 5% sodium taurocholate into the cholangiopancreatic duct. Two days before modeling, Yihuo Qingyi Decoction was intragastrically administrated, and r-Sak was intraperitoneally injected. The survival rate within 18 h after modeling was determined. The pancreatic blood flow, the weight of ascites, and the serum amylase and lipase were investigated at 6 h, 12 h, and 18kh after modeling, and the pancreatic tissue was examined under light microscopy to see its pathological change. Results: The 18 h survival count of group A,B,C,D and E rats was 9,2,6,7 and 8 respectively. After r-Sak and Yihuo Qingyi Decoction intervention, the serum amylase and lipase and the weight of ascites were significantly decreased, especially in group E.18 h after modeling, the level of the serum amylase and lipase and the weight of ascites in group E was 1 100±118 U·L-1,1 000±150 U·L-1 and 13.40±1.80 g respectively, obviously lower than that of group B (P<0.05).After SAP was induced, the pancreatic blood flow showed a tendency to decrease, but the decrease extent in the treatment groups was smaller than that in the control group.18h after modeling, the pancreatic blood flow in group B and group E was 30.16±8.96 mL·100 g-1·min-1,and 129.10±42.58 mL·100 g-1·min-1 respectively, there was significant difference (P<0.05). The pathological change of the pancreatic tissue was alleviated in the treatment groups. Conclusion: Both r-Sak and Yihuo Qingyi Decoction play a beneficial role in the treatment of rat SAP and there is a synergistic effect between the two.