Effect of combined therapy of Yinchenhao Chengqi decoction and endoscopic sphincterotomy for endotoxemia in acute cholangitis

AIM To evaluate the therapeutic mechanism of Yinchenhao Chengqi (YCHCQ) decoction (containing mainly Herba Artemisia capillaris) combined with endoscopic sphincterotomy (EST) for endotoxemia (ETM) in acute cholangitis.METHODS Twenty-one cases of acute cholangitis with ETM were divided randomly into two groups: group A, 10 patients treated with YCHCQ decoction combined with EST, group B, 11 patients treated with EST. The incidence rate of ETM, plasmic ET, serum superoxide dismutase (SOD) activity, malonyldialdehyde (MDA), complement C3 and C-reactive protein (CRP) were studied respectively.RESULTS The ET level of group A (35.92ng/L±8.30ng/L) was significantly reduced after 7 days of treatment (P＜0.05) in contrast to that of group B (47.8ng/L±11.62ng/L), so did the level of MDA and CRP. But the SOD activity and C3 level in group A increased significantly (P＜0.05).CONCLUSION YCHCQ decoction combined with EST had a beneficial effect for ETM in acute cholangitis.INTRODUCTIONEndotoxemia (ETM) is one of the most important physiopathologic causes of acute cholangitis and it is the trigger of cytokines and inflammatory factors. In recent studies it has been found that Yinchenhao Chengqi (YCHCQ) decoction has a beneficial effect on ETM in acute cholangitis. With the development of endoscopic surgery, endoscopic sphincterotomy (EST) has become an effective replacement for some operations in the treatment of acute cholangitis[1]. The effect of YCHCQ decoction combined with EST on ET, oxygen free radical and complement C3 was observed in order to find out its therapeutic mechanism.

Effects of Chai-Qin-Cheng-Qi Decoction on cefotaxime in rats with acute necrotizing pancreatitis

AIM:To investigate the effect of Chai-Qin-Cheng-Qi Decoction(CQCQD)on cefotaxime(CTX)concentration in pancreas of rats with acute necrotizing pancreatitis (ANP). METHODS:Sixty healthy male Sprague-Dawley rats were divided randomly into an ANP group(ANP model +CTX,n=20),treatment group(ANP model+CTX +CQCQD,n=20)and control group(normal rats+ CTX,n=20).ANP models were induced by retrograde intraductal injection of 3.5%sodium taurocholate (1 mL/kg),and the control group was injected intraductally with normal saline.All rats were injected introperitoneally with 0.42 g/kg CTX(at 12-h intervals for a continuous 72 h)at 6 h after intraductal injection. Meanwhile,the treatment group received CQCQD (20 mL/kg)intragastrically at 8-h intervals,and the ANP and control group were treated intragastrically with normal saline.At 15 min after the last CTX injection,blood and pancreas samples were collected for the determination of CTX concentration using validated high-performance liquid chromatography. Pathological changes and wet-to-dry-weight(W/D) ratio of pancreatic tissue were examined. RESULTS:Serum CTX concentrations in three groups were not significantly different.Pancreatic CTXconcentration and penetration ratio were lower in ANP group vs control group(4.4±0.6μg/mL vs 18.6± 1.7μg/mL,P=0.000;5%vs 19%,P=0.000),but significantly higher in treatment group vs ANP group (6.4±1.7μg/mL vs 4.4±0.6μg/mL,P=0.020;7% vs 5%,P=0.048).The histological scores and W/D ratio were significantly decreased in treatment group vs ANP and control group. CONCLUSION:CQCQD might have a promotive effect on CTX concentration in pancreatic tissues of rats with ANP.

Comparison on Traditional and Machinery Decoctions for Da-cheng-qi Decoction Based on Chemical Ingredients, Pharmacological Functions, and Clinical Trials

Objective Patients and doctors often have questions about the equivalence of traditional and machinery decoctions. In this article, using Da-cheng-qi Decoction（DCQD） as a model of formula, traditional decoction（TD）, machinery decoction under high pressure（MDHP）, and machinery decoction under normal pressure（MDNP） were compared. Methods For chemical components, HPLC fingerprints were established and evaluated using AHP combined with CRITIC weighing method; For animals＇ effects, the experiments of small intestinal propulsion were conducted; For clinical effects, a randomized clinical trial（RCT） was designed and performed. Results Although there were some differences between TD and MDNP in chemical ingredients, there was no significant difference in animal experiments and clinical trials（P 〉 0.05）. Conclusion The traditional and machinery decoctions of DCQD could be used bioequivalently.

Identification of active compound combination contributing to anti-inflammatory activity of Xiao-Cheng-Qi Decoction via human intestinal bacterial metabolism

Human intestinal bacteria play an important role in the metabolism of herbal medicines, leading to the variations in their pharmacological profile. The present study aimed to investigate the metabolism of Xiao-Cheng-Qi decoction(XCQD) by human intestinal bacteria and to discover active component combination(ACC) contributing to the anti-inflammatory activity of XCQD. The water extract of XCQD was anaerobically incubated with human intestinal bacteria suspensions for 48 h at 37 °C. A liquid chromatography-hybrid quadrupole time-of-flight mass spectrometry(LC-Q-TOF/MS) method was performed for identification of the metabolites. In addition, the anti-inflammatory effects of XCQD and biotransformed XCQD(XCQD-BT) were evaluated in vitro with cytokines in RAW264.7 cells induced by lipopolysaccharide(LPS). A total of 51 compounds were identified in XCQD and XCQD-BT. Among them, 20 metabolites were proven to be transformed by human intestinal bacteria. Significantly, a combination of 14 compounds was identified as ACC from XCQD-BT, which was as effective as XCQD in cell models of inflammation. In conclusion, this study provided an applicable method, based on intestinal bacterial metabolism, for identifying combinatory compounds responsible for a certain pharmacological activity of herbal medicines.

Modified Da-Cheng-Qi Decoction reduces intra-abdominal hypertension in severe acute pancreatitis： a pilot study

Background Intra-abdominal hypertension （IAH） is a recognized prognostic marker for severity of severe acute pancreatitis （SAP） and has a strong impact on the clinical course of SAP. Previous studies indicate that a Da-Cheng-Qi Decoction （DCQD） is beneficial in the treatment of SAP. The purpose of this study was to evaluate the effect of modified DCQD on IAH in patients with SAP. Methods Between January 2008 and December 2008, 42 patients from the West China Hospital were randomized into either the DCQD or control group （n=21 in each group）. Mortality, intra-abdominal pressure （lAP）, Acute Physiology and Chronic Health Evaluation II （APACHE II） score, C-reactive protein （CRP）, oxygenation index, Balthazar CT score, rate of renal failure, decompression rate, intensive care unit （ICU） transfer rate, and length of hospital stay （LOS） were compared between the two groups. Results Compared to the control group, the modified DCQD treatment significantly decreased lAP （P 〈0.05） and APACHE II （P 〈0.05） scores on days 4-8, CRP on day 8 （P 〈0.01）, renal failure rate （P 〈0.05）, and LOS （P 〈0.05）. The oxygenation index was significantly improved in the DCQD group compared with the control group （P 〈0.05）. No significant differences in the Balthazar CT score, shock rate, ICU transfer rate, or mortality occurred between the two groups. Conclusions The modified DCQD can effectively relieve IAH and decrease LOS for patients with SAP. Larger clinical trials are needed to confirm these findings.

四磨汤治疗功能性消化不良(肝脾气滞证)的临床疗效及对血清NO、AchE、CCK、SP的影响

目的观察四磨汤口服液对功能性消化不良(肝脾气滞证)的疗效及对血清中NO、AchE、CCK、SP的影响。方法将60例患者随机分为四磨汤加模拟多潘立酮治疗组30例和多潘立酮加模拟四磨汤对照组30例,治疗14 d,观察治疗前后总体疗效、症状总积分、单项症状改善情况及血清中NO、AchE、CCK、SP变化情况。结果经14 d治疗后,两组功能性消化不良患者的临床总有效率差异无统计学意义(P>0.05),而四磨汤在改善部分临床症状方面优于多潘立酮;四磨汤和多潘立酮均能降低功能性消化不良患者血清中NO、CCK的含量,提高功能性消化不良患者血清中AchE、SP的含量,从而调节功能性消化不良患者胃肠运动,且四磨汤对功能性消化不良患者胃肠激素的调节作用优于多潘立酮(P<0.01或P<0.05)。结论四磨汤治疗功能性消化不良疗效确切,对患者血清NO、AchE、CCK、SP含量的调节是其可能作用机制。

四磨汤合承气汤辅助常规西医在老年便秘型肠易激综合征中的应用效果及安全性

目的:分析为老年便秘型肠易激综合征患者提供四磨汤合承气汤辅助常规西医治疗的临床意义。方法:选取2022年3月—2023年6月惠东县人民医院收治的60例老年便秘型肠易激综合征患者作为研究对象,采用随机数表法分为观察组和对照组,每组各30例。对观察组患者采用四磨汤合承气汤辅助常规西医治疗干预,对照组患者采用常规西医治疗,对比两组患者经不同治疗后的差异性情况。结果:观察组患者的中医证候积分控制情况、治疗效果、临床指征以及相关指标改善情况等均优于对照组,差异有统计学意义(P<0.05)。结论:采用四磨汤合承气汤辅助常规西医治疗老年便秘型肠易激综合征患者,有助于改善患者的临床指征以及相关指标,治疗效果理想。

四磨汤对肝脾气滞证功能性消化不良大鼠十二指肠低度炎症及肥大细胞脱颗粒的影响

目的:观察四磨汤对肝脾气滞证功能性消化不良(FD)大鼠十二指肠低度炎症及肥大细胞脱颗粒的影响,探究四磨汤改善肝脾气滞证FD的作用及可能机制。方法:用随机数字表法将60只大鼠分为六组,分别为空白组、模型组、西药组、四磨汤高剂量组、四磨汤中剂量组、四磨汤低剂量组,除空白组外的组别选取不可预知的慢性应激法复制肝脾气滞证FD大鼠模型,造模成功后治疗组大鼠每天同一时间予以相应治疗药物灌胃,模型组大鼠则予以蒸馏水灌胃,每日不限饮食饮水。连续灌胃14 d。期间观察大鼠状态,记录各组大鼠体重及饮食饮水状态,最后检测各组大鼠十二指肠Tryptase基因表达、血清白介素-1β(IL-1β)及肿瘤坏死因子-α(TNF-α)的含量。结果:与空白组相比,模型组大鼠皮毛枯黄,性情暴躁而喜聚集于笼边,饮食饮水量减少且大便稀溏,体重降低(P<0.01),胃排空率和小肠推进率明显下降(P<0.01),十二指肠Tryptase、血清IL-1β及TNF-α的表达均显著增加(P<0.01);与模型组相比,治疗组大鼠温顺,皮毛顺泽,饮食饮水量增加且大便成形,体重增加(P<0.01),胃排空率和小肠推进率明显上升(P<0.01),十二指肠Tryptase基因表达、血清IL-1β及TNF-α含量均显著降低(P<0.01)。结论:四磨汤对肝脾气滞证FD有效且能显著缓解肝脾气滞证FD的十二指肠低度炎症,其机制可能与抑制肥大细胞脱颗粒、减少相关活性物质的释放有关。

LC-MS／MS法研究大承气汤与其君药大黄物质基础间的相关性

目的:从物质基础角度研究大承气汤与其君药大黄间的相关性。方法:采用高效液相色谱/串联质谱联用技术(LC-MS/MS)分析中药经典方剂大承气汤及其君药大黄水提液,研究两者化学成分间的相关性并对主要成分进行结构鉴定和推测。采用Zorbax SB C18色谱柱,0.2%甲酸-甲醇-乙腈三元梯度洗脱,ESI离子源,负离子模式下采集数据。结果:从大承气汤中共发现75个成分源于其君药大黄,经与标准品比对可确定其中9个;利用提取离子流技术(EIC)并结合质谱裂解规律可初步推测其中22个成分的结构。结论:大黄单煎剂中的主要成分在大承气汤中均有所体现;LC-MS/MS技术为中药方剂物质基础溯源、鉴定,方剂与单味药间的相关性研究提供了一种快速准确的方法。

柴芩承气汤对重症急性胰腺炎大鼠胆碱能抗炎通路的影响

目的探讨重症急性胰腺炎(SAP)大鼠血清乙酰胆碱酯酶(TRUE CHOLINE ESTERASE,TCHE)和乙酰胆碱转移酶(CHOLINE ACETYLTRANSFERASE,CHAT)的变化及其与IL-6和TNF-Α相关性以及柴芩承气汤(CHAI QIN CHENGQI DECOCTION,CQCQD)对其的影响。方法将30只SD大鼠随机分成3组(假模手术型组、SAP组和CQCQD治疗组),每组10只。检测各组血生化指标、淀粉酶、TNF-Α、IL-6、TCHE及CHAT。结果SAP组较假手术模型组血清IL-6、TNF-Α及TCHE升高(P<0.01),血清CHAT降低(P<0.01);血清IL-6与TCHE呈正相关(R=0.95,P=0.000),与CHAT呈负相关(R=-0.91,P=0.000);TNF-Α与TCHE呈正相关(R=0.93,P=0.000),与CHAT呈负相关(R=-0.95,P=0.004)。CQCQD治疗组血清IL-6、TNF-Α较SAP组低(P<0.01),血清CHAT较SAP组高(P<0.01)。假手术模型组、CQCQD治疗组和SAP组WBC、ALT、AST及LDH依次升高(P<0.01)。结论胆碱能抗炎通路在SAP大鼠的病理生理过程中起着重要作用。柴芩承气汤可通过影响其功能,减轻全身炎性反应综合征,减少脏器功能受损。

重症急性胰腺炎大鼠促炎抗炎细胞因子的动态变化及大承气汤的调节作用

目的:研究重症急性胰腺炎(SAP)大鼠促炎抗炎细胞因子TNF-α、IL-1、IL-10不同时间点的动态变化及大黄复方的调节作用,探讨大承气汤治疗SAP的作用机制。方法:采用胰胆管逆行注射5%牛磺胆酸钠法建立大鼠SAP模型。将SD大鼠随机分为假手术组、SAP模型组和大承气汤治疗组,观察各组不同时间点血清淀粉酶、TNF-α、IL-1、IL-10水平。结果:SAP模型组与假手术组比较,血清淀粉酶、TNF-α、IL-1水平均明显升高(P<0.01),IL-10水平降低(P<0.01),TNF-α/IL-10比值降低;大承气汤治疗组与SAP比较,血清淀粉酶、TNF-α、IL-1水平明显降低(P<0.01),IL-10水平不同程度上升(P<0.05,P<0.01),TNF-α/IL-10比值回复接近假手术组水平。结论:大承气汤治疗SAP的作用机制可能通过下调IL-1、TNF-α等促炎细胞因子的释放,并一定程度提高抗炎细胞因子IL-10水平,重建促炎和抗炎细胞因子的平衡,进而减轻组织损伤,阻止SAP的进一步发展。

大承气汤对急性胃肠损伤患者免疫功能影响的临床评价

目的:研究通腑中药大承气汤对AGI患者的治疗作用及对机体免疫功能的影响。方法:将69例AGI患者随机分为2组,对照组40例,单纯采用一般对症、补液支持治疗;观察组29例,在对照组治疗的基础上加用口服/灌肠大承气汤汤剂,分别比较治疗前后T淋巴细胞亚群、NK活性、WBC及CRP、PCT、IL-6的改变,并进行APACHEⅡ评分。结果:治疗2周后2组胃肠功能均较前改善,观察组恢复更为迅速(P<0.01);2组经治疗后APACHEⅡ评分较治疗前均有下降(P<0.05),与对照组比较,治疗组评分下降更显著(P<0.01),治疗2周后,观察组NK、CD3^+、CD4^+细胞计数明显升高,CD8^+细胞计数减少,CD4^+/CD8^+比值明显升高,差异有统计学意义;治疗后观察组WBC、CRP、PCT、IL-6表达水平较治疗前明显降低,差异有统计学意义。对照组经治疗后CD3^+、CD4^+细胞数表达下降,而CD8^+细胞数相对增加,CD4^+/CD8^+比值降低;WBC总数、CRP、PCT、IL-6较与治疗前相比,无显著差异。结论:以大承气汤为代表的"通腑法"对AGI患者有较好的通腑逐邪作用,并能通过逐邪来固护正气,恢复机体的免疫功能,提高临床疗效。

大承气汤改善家兔实验性肺水肿及多脏器损害的病理学研究

目的:研究大承气汤改善阳明腑实喘满证中肺通气功能和肺组织病变的机制。方法:将家兔随机分为对照组(A)、治疗组(B)和大承气汤组(C)。从兔耳缘静脉注入油酸建立家兔实验性肺水肿的动物模型。大承气汤以胃管插入进行治疗,观察动物一般情况、血气分析及形态学改变等指标。结果:油酸可以致家兔实验性肺水肿,以肺水肿、肺出血、毛细血管微血栓和肺泡内透明膜形成为主要标志,同时伴多脏器损伤。大承气汤具有改善肺水肿、促进肺泡上皮增生特别是Ⅱ型上皮增生、保护多脏器功能,促进损伤修复的作用。结论:大承气汤的治疗作用可能与其促进水肿液的吸收、促进肺泡上皮增生特别是Ⅱ型上皮增生与修复、改善肺泡/通气血流比例、保护多脏器以及改善内环境等多种作用有关。

大承气汤冲剂术后早期使用的临床观察

目的 :观察大承气汤冲剂术后早期使用促进肠功能早期恢复 ,提高围手术期治疗效果的作用。 方法 :选择上腹部手术病人 10 0例 ,随机分为中药组和对照组。中药组在术后 1～ 3d给予大承气汤冲剂 ,从术后肠音恢复时间、排气、排便和进食时间、肺通气功能和血氧饱和度变化、血浆内毒素及胃动素变化等指标进行了观察。 结果 :术后早期在没有禁忌症条件下 ,服用大承气汤冲剂 ,使进食和排便时间提前 ,加快术后的恢复 ,同时肺功能SaO2 和FEV1 0 (%PRED)也得到改善 ,促进血浆内毒素水平早期下降及胃动素水平提高等。 结论 :术后早期使用大承气汤冲剂具有提高围手术期治疗效果 。

柴芩承气汤对重症急性胰腺炎免疫功能的影响

目的探讨柴芩承气汤对重症急性胰腺炎患者内毒素、白细胞介素-6的影响。方法选取2014年7月—2015年3月在我院接受治疗的重症急性胰腺炎患者100例,按照随机数表法将所有患者分为观察组和对照组各50例,观察组给予柴芩承气汤治疗,对照组给予常规治疗,比较两组患者治疗以后T细胞亚群、IL-6和IL-8、超敏C反应蛋白和内毒素以及临床效果。结果治疗后,观察组患者的CD4^+〔(45.62±2.78)pg/m L〕高于对照组〔(40.23±1.98)pg/m L〕,观察组患者的CD8^+以及CD4^+/CD8^+都有所下降,观察组〔(32.67±1.57)、(1.25±0.10)pg/m L〕低于对照组〔(35.26±3.02)、(1.98±0.37)pg/m L〕,差异显著有统计学意义(P<0.05);治疗后,2组患者的IL-6和IL-8都有所下降,观察组〔(74.26±9.78)、(3.05±0.24)pg/m L〕低于对照组〔(80.64±8.15)、(4.62±0.17)pg/m L〕,差异显著有统计学意义(P<0.05);2组患者的超敏C反应蛋白以及内毒素都有所下降,观察组〔(7.12±0.31)、(0.28±0.05)pg/m L〕低于对照组〔(9.23±1.25)、(0.87±0.08)pg/m L〕,差异显著有统计学意义(P<0.05);观察组治疗后有效率98.00%明显高于对照组80.00%,差异显著有统计学意义(P<0.05)。结论柴芩承气汤可以调节重症胰腺患者免疫功能,利于患者预后。

COPD大鼠AQPs mRNA表达及“从肠论治”干预作用

目的:观察"从肠论治"对COPD模型大鼠AQPs mRNA表达的影响,从津液敷布角度探讨COPD"从肠论治"的效应机制。方法:采用气管注脂多糖加熏香烟联合造模方法建立COPD大鼠模型,随机分为正常组、模型组、治肺组、治肠组及肺肠同治组。正常组、模型组灌胃生理盐水,各给药组灌胃相应中药,连续14天。定时荧光定量PCR法检测肺组织AQP1、AQP3、AQP5mRNA表达水平。结果:与正常组比较,模型组大鼠气道AQP1、AQP3、AQP5mRNA表达减少(P<0.01)。与模型组比较,治肠组AQP1、AQP3、AQP5mRNA表达增强(P<0.05)。与治肺组比较,肺肠同治组AQP1、AQP3、AQP5mRNA表达增强(P<0.01)。结论:通利大肠,或在治肺的基础上增加通利大肠,可增强AQPs mRNA的表达,改善肺脏津液敷布及宣肺功能,这可能是COPD"从肠论治"效应产生的作用环节之一。

加减四磨汤治疗慢性便秘气滞型的临床观察

目的:观察加减四磨汤治疗慢性便秘气滞型(Chronic Constipation of Stagnation of QI,CCSQ)的疗效和安全性。方法:将95例CCSQ患者随机分成A组(加减四磨汤治疗组),B组(普卢卡必利对照组),首要观察12周治疗后自然完全排便次数(Spontaneous,Complete Bowel Movements,SCBM)≥3次/周的比例,次要观察SCBM增加≥1次/周的患者比例,并比较入组前及第4、6、12周便秘患者生活质量量表(Patient Assessment of Constipation Quality of Life,PAC-QOL)。同时记录不良事件。结果:在12周的疗程中,A组SCBM≥3次/周的比例是42.55%,B组为29.17%,A组显著高于B组(P=0.013);A组SCBM增加≥1次/周的患者比例是61.70%,B组为43.75%,A组显著高于B组(P=0.004)。通过比较入组前及第4、6、12周PAC-QOL,加减四磨汤在改善CCSQ患者的生活质量方面明显优于普卢卡必利。最常见的不良反应是恶心、头痛、腹泻、腹痛,未出现明显的心血管事件。结论:CCSQ应用加减四磨汤安全、有效。

柴芩承气汤对重症急性胰腺炎并发肝损伤大鼠的治疗作用及其机制

目的:研究柴芩承气汤(CQCQD)对重症急性胰腺炎(SAP)并发肝损伤大鼠的治疗作用及其机制。方法:72只SD大鼠随机分为3组(n=24):假手术(sham)组,重症急性胰腺炎模型(SAP)组和柴芩承气汤治疗(CQCQD)组。去氧胆酸钠胰胆管逆行注射建立SAP大鼠模型,CQCQD组给予柴芩承气汤治疗,于造模后1 h、5 h、10 h观察各组不同时间点的胰腺、肝脏组织病理学变化,检测血清中淀粉酶(AMS)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)活性、白介素-6(IL-6)水平及胰腺、肝脏组织单核细胞趋化蛋白-1(MCP-1)和IL-6 mRNA的表达情况。结果:与sham组比较,SAP组血清AMS、ALT、AST活性及IL-6水平明显升高,胰腺、肝脏组织MCP-1及IL-6 mRNA表达升高(P<0.05);与SAP组比较,CQCQD组血清AMS、ALT、AST活性及IL-6水平明显降低;胰腺和肝脏组织病理损伤减轻,胰腺、肝脏组织MCP-1及IL-6 mRNA表达明显减弱(P<0.05)。结论:MCP-1参与了SAP并发肝损伤的进展;柴芩承气汤能显著抑制胰腺、肝脏组织MCP-1的表达,减轻SAP时胰腺、肝脏组织病理损伤,对SAP并发肝损伤起到治疗作用。

柴芍承气汤对重症急性胰腺炎患者炎症介质的影响

目的探讨中药柴芍承气汤治疗重症急性胰腺炎（SAP）的作用机制。方法选择本院住院治疗的SAP患者30例，按随机数字表法分西医常规治疗组和加用柴芍承气汤中西医结合治疗组，每组15例。另以同期10例健康志愿者为健康对照组。采用双抗体夹心卵白素-生物素-过氧化物酶（ABC）-酶联免疫吸附试验（ELISA）测定患者于入院时及治疗3、5、7d血清白细胞介素（IL-6、IL-15）、巨噬细胞抑制因子（MIF）的含量，观察患者腹痛、腹胀、腹部压痛缓解、肠鸣音恢复时间及死亡情况。结果入院时两个治疗组SAP患者血清IL-6、IL-15、MIF浓度均显著高于健康对照组（均P〈0．05）；随治疗时间延长，上述指标呈下降趋势，以中西医结合组下降明显，并于治疗7d时达谷值，且与西医组同期比较差异有统计学意义[IL-6（ng／L）：246．34±86．65比724．88±110．89，IL-15（ng／L）：158．81±50．63比403．04±134．83，MIF（ng／L）：121．90±29．48比240．60±67．36，均P〈0．05]。中西医结合组肠道功能恢复时间较西医组显著缩短[腹痛缓解时间（h）：95．87±32．56比149．33±35．89，腹胀缓解时间（h）：137．07±41．67比191．87±32．08，腹部压痛缓解时间（h）：128．93±40．60比189．73±33．31，肠鸣音恢复时间（h）：88．53±31．71比128．00±30．92，均P〈0．05]。西医组死亡2例，中西医结合组无死亡，但两组比较差异无统计学意义（P〉O．05）。结论中药柴芍承气汤结合常规西医方法治疗SAP疗效优于单纯西医治疗，其作用机制可能与降低血清IL-6、IL-15和MIF水平有关。