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目的:研究通腑清胰方辅助治疗重症急性胰腺炎(SAP)的疗效,并且探讨其对肠道黏膜屏障功能和免疫功能的影响。方法:2012年1月~2013年12月在浙江省富阳市人民医院就诊的112例SAP患者按随机数字表分为观察组和对照组,每组各56例。对照组患者接受常规治疗,观察组患者在常规治疗的基础上加服通腑清胰方,两组疗程均为14天。于治疗前及治疗14天对两组患者肠道黏膜屏障功能和免疫功能进行评估,比较两组患者治疗后肠麻痹恢复时间和APACHEⅡ评分,并对两组患者的临床疗效进行评价。结果:(1)治疗后观察组患者的腹痛缓解时间、腹胀缓解时间、肠鸣音恢复时间和首次排便时间均较对照组显著缩短(P<0.01);(2)治疗后两组患者APACHEⅡ评分均较治疗前显著降低(P<0.01),且治疗后7、14天时观察组患者APACHEⅡ评分显著低于对照组(P<0.01);(3)治疗14天时观察组患者血清内毒素、D-乳酸、二胺氧化酶、淀粉酶水平均较对照组显著降低(P<0.01);(4)治疗14天时观察组患者CD4+、CD4+/CD8+和Treg细胞较对照组患者显著升高(P<0.01),CD8+较对照组患者显著降低(P<0.01);(5)观察组患者的总有效率显著高于对照组(P<0.05)。结论:通腑清胰方辅助治疗重症急性胰腺炎有较好的疗效,可改善重症急性胰腺炎患者肠道黏膜屏障功能和免疫功能。
Objective: To study the curative effect of Tongfu Qingyao prescription in the treatment of severe acute pancreatitis (SAP), and to explore its effect on intestinal mucosal barrier function and immune function. Methods: From January 2012 to December 2013, 112 SAP patients treated in Fuyang People’s Hospital of Zhejiang Province were divided into observation group and control group according to random number table, 56 cases in each group. Patients in the control group received routine treatment. The patients in the observation group were given Tongfu Qingyao prescription on the basis of routine treatment. The two courses of treatment both were 14 days. The intestinal mucosal barrier function and immune function of two groups were evaluated before treatment and 14 days after treatment. The recovery time of intestinal paralysis and APACHEⅡ score were compared between the two groups after treatment, and the clinical efficacy of the two groups was evaluated. Results: (1) The pain relief time, abdominal distension time, bowel sound recovery time and first defecation time in the observation group were significantly shorter than those in the control group after treatment (P <0.01); (2) APACHEⅡscore APACHEⅡscore in observation group was significantly lower than that in control group at 7 and 14 days after treatment (P <0.01); (3) Serum endotoxin, D- (4) The levels of CD4 +, CD4 + / CD8 + and Treg cells in the observation group were significantly higher than those in the control group on the 14th day after treatment (P <0.01), while the levels of lactate, diamine oxidase and amylase in the observation group were significantly lower than those in the control group (P <0.01). (5) The total effective rate in the observation group was significantly higher than that in the control group (P <0.05). Conclusion: Tongfu Qingyao prescription is effective in treating severe acute pancreatitis and can improve intestinal mucosal barrier function and immune function in patients with severe acute pancreatitis.