世界中医药
文章摘要
引用本文:冯勇,谭冬梅,李彬,蒲静,王娟.柴芩承气汤对急性重症胰腺炎的疗效观察及部分机制[J].世界中医药,2019,(11):.  
柴芩承气汤对急性重症胰腺炎的疗效观察及部分机制
Efficacy Observation and Partial Mechanism Exploration on Chaiqin Chengqi Decoction in Severe Acute Pancreatitis
投稿时间:2018-11-30  
DOI:10.3969/j.issn.1673-7202.2019.11.025
中文关键词:  柴芩承气汤  急性重症胰腺炎  淀粉酶  炎性反应  免疫功能  淋巴细胞亚群  临床疗效  不良反应
English Keywords:Chaiqin Chengqi Decoction  Severe acute pancreatitis  Amylase  Inflammatory response  Immune function  Lymphocyte subgroup  Clinical efficacy  Adverse drug reaction incidence
基金项目:四川省卫生厅科研课题立项(110544)
作者单位
冯勇,谭冬梅,李彬,蒲静,王娟 四川省绵阳市中心医院中西医结合科绵阳621000 
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中文摘要:
      目的:探究柴芩承气汤加减联合西医治疗急性重症胰腺炎的临床效果,并对其作用机制进行研究,以期丰富治疗方法,降低急性重症胰腺炎并发症,提高疗效。方法:选取2017年1月至2018年2月绵阳市中心医院收治的急性重症胰腺炎患者62例作为研究对象,按照就诊顺序编号,采用数字随机表法分为对照组和观察组,每组31例。对照组给予心电监护、禁食禁饮、胃肠减压、抑酸、维持内环境稳定、抗菌、抑制胰腺分泌和胰腺活性、止痛等治疗,观察组在对照组基础上加用柴芩承气汤加减治疗,且经胃管给药,均同时治疗2周。观察2组治疗前、治疗后血清淀粉酶、脂肪酶变化并比较;观察治疗前、治疗后在白细胞(WBC)、超敏C反应蛋白(hs-CRP)、内毒素、白细胞介素-6(IL-6)变化并比较;观察治疗前、治疗后在免疫功能指标CD4+、CD8+、CD4+/CD8+情况并比较;治疗过程中进行不良反应观察并比较;治疗后进行疗效比较。结果:1)2组患者治疗前血淀粉酶、尿淀粉酶、脂肪酶比较,差异无统计学意义(P>0.05),治疗后2组以上指标较治疗前显著下降,差异有统计学意义(P<0.05),治疗后观察组患者以上指标显著低于对照组,差异有统计学意义(P<0.05);2)2组患者治疗前WBC、CRP、内毒素、IL-6指标比较,差异无统计学意义(P>0.05),治疗后以上指标2组较治疗前均显著下降,差异有统计学意义(P<0.05),治疗后观察组患者以上指标显著低于对照组,差异有统计学意义(P<0.05)。3)2组患者治疗前CD4+、CD8+、CD4+/CD8+比较,差异无统计学意义(P>0.05),治疗后CD4+、CD8+、CD4+/CD8+2组较治疗前显著升高,CD8+则显著下降,差异有统计学意义(P<0.05),治疗后观察组患者以上指标显著优于对照组,差异有统计学意义(P<0.05)。4)完成治疗后观察组患者治愈率、总有效率明显高于对照组,差异有统计学意义(P<0.05)。5)2组恶心呕吐、腹痛腹泻、头晕不良反应发生率比较,差异无统计学意义(P>0.05)。结论:柴芩承气汤能抑制急性重症胰腺炎血清淀粉酶和脂肪酶,抑制炎性反应,改善免疫力,提高疗效。
English Summary:
      To explore clinical efficacy of modified Chaiqin Chengqi Decoction combined with western medicine in severe acute pancreatitis,and to study its mechanism of action in order to enrich treatment methods,reduce complications of severe acute pancreatitis and improve the efficacy.Methods:A total of 62 patients with severe acute pancreatitis admitted to Mianyang Central Hospital from January 2017 to February 2018 were selected as subjects.They were numbered in order of treatment and divided into control group(31 cases)and observation group(31 cases)according to random number table method.The control group was given ECG monitoring,fasting,fasting water,gastrointestinal decompression,acid suppression,maintaining internal environment stability,antimicrobial,inhibiting pancreatic secretion and pancreatic activity,analgesia and other treatments.The observation group was given modified Chaiqin Chengqi Decoction on the treatment basis of the control group,and was given the medicine through gastric tube.They were treated for 2 weeks.Changes of serum amylase and lipase were observed and compared before and at the end of the treatment; and changes of WBC,CRP,endotoxin and IL-6 were observed and compared before and at the end of the treatment; indexes of immune function like CD4+,CD8+ and CD4+/CD8+ were observed and compared before and at the end of the treatment; adverse reactions during the treatment were observed and compared; and the efficacy at the end of the treatment was compared.Results:1)There was no significant difference in the blood amylase,urine amylase and lipase between the 2 groups before the treatment(P>0.05).At the end of the treatment,the above indexes in the 2 groups were significantly lower than those before the treatment(P<0.05).At the end of the treatment,the above indexes in the observation group were significantly lower than those in the control group(P<0.05).2)There was no significant difference in the WBC,CRP,endotoxin and IL-6 between the 2 groups before the treatment(P>0.05).At the end of the treatment,the above indexes in the 2 groups were significantly lower than those before the treatment(P<0.05).At the end of the treatment,the above indexes in the observation group were significantly lower than those in the control group(P<0.05).3)There was no significant difference in the CD4+,CD8+ and CD4+/CD8+ between the 2 groups before the treatment(P>0.05).At the end of the treatment,the CD4+ and CD4+/CD8+ in the 2 groups were significantly increased compared with those before the treatment,while the CD8+ was significantly decreased(P<0.05).At the end of the treatment,the above indexes in the observation group were significantly better than those in the control group(P<0.05).4)After the treatment,the cure rate and total effective rate in the observation group were significantly higher than those in the control group(P<0.05).5)There was no significant difference in the incidence of nausea,vomiting,abdominal pain,diarrhea and dizziness between the 2 groups(P>0.05).Conclusion:Chaiqin Chengqi Decoction can inhibit serum amylase and lipase,inhibit inflammation response,improve immunity and improve efficacy in severe acute pancreatitis.
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