[1]尹 诗,谢安卫,肖敬鄂,等.二草清胰汤内服及保留灌肠联合乌司他丁治疗急性胰腺炎临床研究[J].陕西中医,2023,(2):183-186,190.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.010]
 YIN Shi,XIE Anwei,XIAO Jing'e,et al.Clinical study of oral administration and retention enema with Ercao Qingyi decoction combined with ulinastatin in the treatment of acute pancreatitis[J].,2023,(2):183-186,190.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.010]
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二草清胰汤内服及保留灌肠联合乌司他丁治疗急性胰腺炎临床研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年2期
页码:
183-186,190
栏目:
临床研究
出版日期:
2023-02-05

文章信息/Info

Title:
Clinical study of oral administration and retention enema with Ercao Qingyi decoction combined with ulinastatin in the treatment of acute pancreatitis
作者:
尹 诗谢安卫肖敬鄂刘洪恩胡维林韩 俊
(广安市人民医院,四川 广安 638099)
Author(s):
YIN ShiXIE AnweiXIAO Jing'eLIU Hong'enHU WeilinHAN Jun
(Guang'an People's Hospital,Guang'an 638099,China)
关键词:
急性胰腺炎 二草清胰汤 保留灌肠 乌司他丁 胰酶分泌 细胞因子
Keywords:
Acute pancreatitis Ercao Qingyi decoction Retention enema Ulinastatin Pancreatic enzyme secretion Cytokines
分类号:
R 657.5
DOI:
DOI:10.3969/j.issn.1000-7369.2023.02.010
文献标志码:
A
摘要:
目的:探讨自拟二草清胰汤内服及保留灌肠联合乌司他丁对急性胰腺炎(AP)患者临床疗效、胰酶分泌及细胞因子的影响。方法:146例AP患者采用随机数字表法分为两组,各73例。对照组予乌司他丁治疗,观察组在此基础上增加自拟二草清胰汤内服及保留灌肠治疗,均连续治疗7 d。观察两组疗效,比较两组治疗前后中医症状积分,测定胰酶、细胞因子水平,记录症状缓解时间。结果:观察组总有效率为93.15%,高于对照组的76.71%(P<0.05)。观察组入院第7 天上腹胀痛、胸脘满闷、恶心呕吐、大便秘结、尿短赤黄症状积分及血清淀粉酶(AMY)、脂肪酶(LPS)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平明显低于对照组,白细胞介素2(IL-2)水平明显高于对照组(P<0.05)。观察组肠鸣音恢复时间、腹痛缓解时间、体温恢复正常时间及恶心呕吐消失时间均较对照组缩短(P<0.05)。结论:二草清胰汤内服及保留灌肠联合乌司他丁可提升AP疗效,缓解患者临床症状,改善胰酶分泌并调节细胞因子水平。
Abstract:
Objective:The purpose of this study was to investigate the clinical effect of oral administration and retention enema with self-made Ercao Qingyi decoction combined with ulinastatin in the treatment of patients with acute pancreatitis(AP),and the influence on pancreatic enzyme secretion and cytokines.Methods:A total of 146 patients with AP were divided into two groups by the random number table method,with 73 cases in each group.Patients in the control group were treated with ulinastatin.On this basis,patients in the observation group were treated with oral administration and retention enema with self-made Ercao Qingyi decoction.Both groups received 7 d of treatment,and the curative effect was observed.TCM symptom scores of the two groups were compared before and after treatment.The levels of pancreatic enzymes and cytokines were measured,and symptom relief time was recorded.Results:The total effective rate in the observation group was higher than that in the control group(P<0.05).The scores for epigastric distention,chest distress,nausea and vomiting,constipation,less and dark urine,serum amylase(AMY),lipase(LPS),high-sensitivity C-reactive protein(hs-CRP),interleukin 6(IL-6)and tumor necrosis factor alpha(TNF-α)levels in the observation group on day 7 after admission were significantly lower than those in the control group,and the level of interleukin-2(IL-2)was significantly higher than that in the control group(P<0.05).The recovery time of bowel sounds,time until relief of abdominal pain,recovery time of body temperature,and the disappearance time of nausea and vomiting were shorter in the observation group than in the control group(P<0.05).Conclusion:Oral administration and retention enema with self-made Ercao Qingyi decoction combined with ulinastatin can improve the curative effect on AP,relieve the clinical symptoms,improve the secretion of pancreatic enzymes,regulate the levels of cytokines.

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备注/Memo

备注/Memo:
基金项目:四川省中医药管理局科研课题(2020CP0011)
更新日期/Last Update: 2023-02-08