[1]俞 慧,杨 挺△,黄 伟.大黄承气汤联合保留灌肠对重症急性胰腺炎肠道菌群及免疫功能的影响*[J].陕西中医,2020,(10):1418-1421.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.021]
　YU Hui,YANG Ting,HUANG Wei..Effect of Dahuang Chengqi decoction combined with retention enema on intestinal flora and immune function in severe acute pancreatitis[J].,2020,(10):1418-1421.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.021]
点击复制

大黄承气汤联合保留灌肠对重症急性胰腺炎肠道菌群及免疫功能的影响*
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2020年10期
页码:
1418-1421
栏目:
临床研究
出版日期:
2020-10-05

文章信息/Info

Title:
Effect of Dahuang Chengqi decoction combined with retention enema on intestinal flora and immune function in severe acute pancreatitis
作者:
俞 慧; 杨 挺△; 黄 伟
江南大学附属医院(无锡市第三人民医院)急诊科(无锡 214000)
Author(s):
YU Hui; YANG Ting; HUANG Wei.
Emergency Department,Affiliated Hospital of Jiangnan University(Third People's Hospital of Wuxi )(Wuxi 214000)
关键词:
重症急性胰腺炎;  大黄承气汤;  保留灌肠;  肠道菌群;  免疫功能;  病死率
Keywords:
Severe acute pancreatitis;  Dahuang Chengqi decoction;  Retention enema;  Intestinal flora;  Immune function;  Mortality
分类号:
R657.51
DOI:
DOI:10.3969/j.issn.1000-7369.2020.10.021
文献标志码:
A
摘要:
目的:探讨大黄承气汤联合保留灌肠对重症急性胰腺炎的肠道菌群及免疫功能的影响。方法:选择重症急性胰腺炎患者100例,按照入组先后顺序分为观察组和对照组各50例。对照组予以常规处理措施,观察组联合大黄承气汤保留灌肠治疗,均持续治疗10 d。比较治疗后临床疗效、胃肠功能恢复时间、住院时间、肠道菌群数量、免疫功能、不良反应及死亡率。结果:观察组临床疗效总有效率为92.00%,明显比对照组的74.00%更高(P<0.05); 观察组腹痛及腹胀消失时间、肠鸣音恢复时间、肛门排气时间、住院时间均明显比对照组短(P<0.05); 治疗后,两组肠球菌、大肠埃希菌数量较治疗前均降低,乳酸杆菌、双歧杆菌数量均升高(P<0.05),观察组改善程度明显优于对照组(P<0.05); 治疗后,两组CD3+、CD8+、CD4+/CD8+较治疗前均升高(P<0.05),且观察组上述指标均明显高于对照组(P<0.05); 治疗期间两组均无明显相关药物不良反应,与对照组的死亡率20.00%相比,观察组6.00%明显更低(P<0.05)。结论:大黄承气汤联合保留灌肠在重症急性胰腺炎患者中的治疗效果明显,可帮助患者调节肠道菌群,促进免疫功能改善,降低病死率。
Abstract:
Objective:To study the effect of Dahuang Chengqi decoction combined with retention enema on intestinal flora and immune function in severe acute pancreatitis.Methods:100 patients of severe acute pancreatitis were divided into observation group and control group by the order of enrollment,with 50 cases in each group.The control group was treated with routine treatment,the observation group was combined with Dahuang Chengqi decoction and retention enema,they were treated for 10 days.After treatment 10 days,gastrointestinal function recovery time,hospitalization time,number of intestinal flora,immune function,adverse reactions and mortality were compared between the two groups.Results:The total effective rate results in the observation group was 92.00%,which was significantly higher than the control group 74.00%(P<0.05); the abdominal pain and distention disappearance time,bowel sounds recovery time,anal exhaust time and hospitalization in the observation group were significantly shorter than the control group(P<0.05); after treatment,the number of Enterococcus and Escherichia coli in the two groups were decreased,and the number of Lactobacillus and Bifidobacterium were increased(P<0.05); the improvement in the observation group were better than the control group(P<0.05); after treatment,the CD3+,CD8+ and CD4+/CD8+ in the two groups were higher than before treatment(P<0.05); the above indexes in the observation group were significantly higher than the control group(P<0.05); during the treatment,there was no significant adverse drug reaction in both groups,in the mortality,compared with 20.00% of the control group,the observation group was 6.00%,significantly lower(P<0.05).Conclusion:Dahuang Chengqi decoction combined with retention is well for severe acute pancreatitis,which can help patients adjust intestinal flora,improve the immune function,reduce the mortality.

参考文献/References:

[1] Sundar V,Senthil KKA,Manickam V,et al.Current trends in pharmacological approaches for treatment and management of acute pancreatitis-a review[J].The Journal of Pharmacy and Pharmacology,2020,72(6):761-775.
[2] Biberci KE,Taslidere B,Kochan K,et al.Comparison of scoring systems used in acute pancreatitis for predicting major adverse events[J].Gastroenterologia Y Hepatologia,2020,43(4):193-199.
[3] 姜 萌,赵 鹏.奥曲肽联合加贝酯治疗重症急性胰腺炎疗效及对患者血清细胞因子水平的影响[J].陕西医学杂志,2020,49(2):212-215.
[4] 周胜前.通腑清胰汤辅助连续性血液净化治疗重症胰腺炎及对肠道屏障功能和血清内毒素、PAF和TNF-α水平的影响[J].四川中医,2019,37(6):100-102.
[5] 中华医学会消化病学分会胰腺疾病学组,中华胰腺病杂志编辑委员会,中华消化杂志编辑委员会.中国急性胰腺炎诊治指南(2013年,上海)[J].中华消化杂志,2013,33(4):217-222.
[6] 中华中医药学会脾胃病分会.急性胰腺炎中医诊疗专家共识意见[J].中华中医药杂志,2013,28(6):1826-1831.
[7] 杨 静,田永明,刘 欢,等.King氏达标理论对ICU重症急性胰腺炎患者负性情绪及预后的影响[J].中国急救复苏与灾害医学杂志,2019,14(10):995-998.
[8] Lee B,Zhao Q,Habtezion A.Immunology of pancreatitis and environmental factors[J].Current Opinion in Gastroenterology,2017,33(5):383-389.
[9] 任金涛,康 焰,崔 勇.大柴胡汤联合连续血液净化治疗急性重症胰腺炎疗效及对血清生化指标、免疫功能与炎性因子的影响研究[J].陕西中医,2018,39(2):154-156.
[10] Munoz LE,Leppkes M,Fuchs TA,et al.Missing in action-The meaning of cell death in tissue damage and inflammation[J].Immunological Reviews,2017,280(1):26-40.
[11] 焦 旭,卢 云.中医药治疗急性胰腺炎的临床进展[J].中国中医急症,2016,25(10):1922-1925.
[12] 孙 武,刘宝清,杨成城,等.中医外治法在急性胰腺炎防治中的运用[J].天津中医药大学学报,2019,38(2):200-204.
[13] 张洁慧,肖铁刚,阙任烨,等.大承气汤治疗胃肠功能障碍的临床及作用机制研究进展[J].中国中西医结合消化杂志,2019,27(1):72-76.
[14] 朱丽娜,朱京慈.大承气汤防治胃肠动力不足作用机制的研究进展[J].中成药,2014,36(12):2591-2594.
[15] 傅志泉,李 珍,曹红燕,等.大承气汤对急性胃肠损伤患者免疫功能影响的临床评价[J].世界中医药,2016,11(9):1707-1710.
[16] 李 军.大黄附子汤治疗危重脓毒症疗效及对患者胃肠功能改善研究[J].陕西中医,2019,40(6):718-721.
[17] 方雪红,曹钏宏,管来顺.芒硝外敷联合血必净治疗急性胰腺炎临床疗效观察[J].陕西中医,2015,36(8):1039-1041.
[18] 孙德阳,杨 洋,梁 群.中医药治疗脓毒症急性肺损伤的研究进展[J].辽宁中医杂志,2019,46(5):1108-1110.

相似文献/References:

[1]马明和,刘永萍,刘 萍,等.攻下清热活血方对重症急性胰腺炎大鼠血清相关炎性因子及肠黏膜屏障功能的影响研究*[J].陕西中医,2020,(8):1051.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.009]
　MA Minghe,LIU Yongping,LIU Ping,et al.Gongxia Qingre Huoxue herb of TCM on serum inflammatory factors and intestinal mucosal barrier function in rats with severe pancreatitis[J].,2020,(10):1051.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.009]
[2]郭迎雪,崔大鹏,聂双发,等.柴芩承气汤早期内服与灌肠联合高强度综合疗法治疗重症急性胰腺炎临床研究[J].陕西中医,2022,(8):1041.[doi:DOI:10.3969/j.issn.1000-7369.2022.08.012]
　GUO Yingxue,CUI Dapeng,NIE Shuangfa,et al.Observation on the clinical efficacy of early oral administration and enema combined with high-intensity comprehensive therapy of Chaiqin Chengqi decoction in the treatment of severe acute pancreatitis[J].,2022,(10):1041.[doi:DOI:10.3969/j.issn.1000-7369.2022.08.012]
[3]张建茹,张 英,张 雨,等.清胰汤加减治疗重症急性胰腺炎疗效研究[J].陕西中医,2022,(9):1230.[doi:DOI:10.3969/j.issn.1000-7369.2022.09.018]
　ZHANG Jianru,ZHANG Ying,ZHANG Yu,et al.Clinical study on modified Qingyi decoction in treatment of patients with severe acute pancreatitis[J].,2022,(10):1230.[doi:DOI:10.3969/j.issn.1000-7369.2022.09.018]
[4]黄 璟,姜 爽.消炎利胆汤联合乌司他丁治疗重症急性胰腺炎肝胆湿热证临床研究[J].陕西中医,2023,(6):717.[doi:DOI:10.3969/j.issn.1000-7369.2023.06.007]
　HUANG Jing,JIANG Shuang.Observation on the effect of Xiaoyan Lidan decoction combined with ulinastatin in the treatment of liver-biliary dampness and heat syndrome of severe acute pancreatitis[J].,2023,(10):717.[doi:DOI:10.3969/j.issn.1000-7369.2023.06.007]
[5]杨 林,汪 念,周晓黎,等.通腑合剂对腑实热结型重症急性胰腺炎患者肠黏膜屏障功能及炎症因子的影响[J].陕西中医,2024,(4):481.[doi:DOI:10.3969/j.issn.1000-7369.2024.04.010]
　YANG Lin,WANG Nian,ZHOU Xiaoli,et al.Effects of Tongfu mixture on intestinal mucosal barrier function and inflammatory factor in sever acute pancreatitis of heat stagnation and Fu-organ excess type[J].,2024,(10):481.[doi:DOI:10.3969/j.issn.1000-7369.2024.04.010]

备注/Memo

备注/Memo:
*江苏省无锡市卫生和计划生育委员会科研项目(MS201415)
更新日期/Last Update: 2020-10-10