[1]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):1230-1233.[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,(9):1230-1233.[doi:DOI:10.3969/j.issn.1000-7369.2022.09.018]
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清胰汤加减治疗重症急性胰腺炎疗效研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2022年9期
页码:
1230-1233
栏目:
临床研究
出版日期:
2022-09-05

文章信息/Info

Title:
Clinical study on modified Qingyi decoction in treatment of patients with severe acute pancreatitis
作者:
张建茹1; 张 英1; 张 雨1; 卢利军2
(1.秦皇岛市第二医院,河北 秦皇岛 066600; 2.空军第九八六医院第五门诊部,陕西 西安 710054)
Author(s):
ZHANG Jianru; ZHANG Ying; ZHANG Yu; LU Lijun
(The Second Hospital of Qinhuangdao,Qinhuangdao 066600,China)
关键词:
重症急性胰腺炎;  清胰汤加减;  连续性肾脏替代疗法;  炎症反应;  活动性肠肽;  微管相关蛋白1轻链3
Keywords:
evere acute pancreatitis;  Modified Qingyi decoction;  Continuous renal replacement therapy;  Inflammatory response;  Vasoactine intrestinal peptide;  Microtubule-associated protein 1 light chain 3
分类号:
R 657.5
DOI:
DOI:10.3969/j.issn.1000-7369.2022.09.018
文献标志码:
A
摘要:
目的:分析清胰汤加减治疗重症急性胰腺炎(SAP)疗效及对血清炎症指标影响。方法:选取SAP患者86例,按随机数字表法分为研究组(n=43)、对照组(n=43)。对照组予生长抑素及连续性肾脏替代疗法(CRRT),研究组在对照组基础上予清胰汤加减治疗,两组均治疗1周。比较两组临床疗效、症状改善时间,治疗前后疾病严重程度、血清炎症指标、疾病相关因子。结果:研究组肛门排便恢复时间、腹痛消失时间、腹胀消失时间、发热消失时间、肠鸣音恢复时间均短于对照组,差异有统计学意义(均P<0.05)。治疗后,两组急性生理与慢性健康状况(APACHEⅡ)得分、全血白细胞计数(WBC)、血清活动性肠肽(VIP)、微管相关蛋白1轻链3(MAP1-LC3)、髓样细胞触发受体-1(TREM-1)、血清C反应蛋白(CRP)、血淀粉酶(AMS)水平均较治疗前降低,且研究组低于对照组,差异有统计学意义(均P<0.05)。治疗后,研究组总有效率高于对照组,差异有统计学意义(P<0.05)。结论:清胰汤加减联合CRRT治疗SAP效果较好,可促进临床症状消失、降低疾病严重程度,其机制可能与调节机体疾病相关因子水平,抑制炎症反应有关。
Abstract:
Objective:To analyze efficacy of modified Qingyi decoction in the treatment of patients with severe acute pancreatitis(SAP)and effect of levels of serum inflammatory indexes.Methods:86 patients with SAP were divided into the study group(n=43)and the control group(n=43)by random number table method.The control group received somatostatin and continuous renal replacement therapy(CRRT)treatment,and the study group received the modified Qingyi decoction on the basis of the control group.Both groups were treated for one week.The clinical efficacy,symptom improvement time and disease severity,serum inflammatory indexes,disease-related factors before and after treatment were compared between the two groups.Results:The recovery time of anal defecation,abdominal pain,abdominal distension,fever and bowel sounds in the study group were all shorter than those in the control group(all P<0.05).After treatment,the score of acute physiology and chronic health status(APACHE Ⅱ),the levels of complete blood white blood cell(WBC),serum vasoactine intrestinal peptide(VIP),microtubule-associated protein 1 light chain 3(MAP1-LC3),triggering receptors expressed on myeloid cells-1(TREM-1),C-reactive protein(CRP)and amylase(AMS)in the study group were lower than those before treatment,and the study group were lower than those in the control group(all P<0.05).After treatment,the total effective rate in the study group was higher than that in the control group,difference statistically significant(P<0.05).Conclusion:Modified Qingyi decoction combined with CRRT has definite curative effect in the treatment of patients with SAP,which colud accelerate the disappearance of clinical symptoms and reduce the severity of disease,analysis related to the regulation of the level of the body's disease-related factors and the inhibition of inflammatory response.

参考文献/References:

[1] 孙 备,杨伟光.重症急性胰腺炎外科干预方式的选择与评价[J].中华急诊医学杂志,2019,28(10):1188-1191.
[2] 张云云,巩想平.埃索美拉唑联合奥曲肽、生长抑素治疗重症胰腺炎疗效及对患者血乳酸水平、肠道黏膜屏障功能的影响[J].陕西医学杂志,2021,50(11):1420-1422,1426.
[3] Habtezion A,Gukovskaya AS,Pandol SJ.Acute pancreatitis:A multifaceted set of organelle and cellular interactions[J].Gastroenterology,2019,156(7):1941-1950.
[4] 庞克斌,刘军昌,李晓光.大黄牡丹汤灌肠对重症急性胰腺炎患者炎症反应及微循环的影响[J].贵州医药,2019,43(4):605-607.
[5] 王春友,李 非,赵玉沛,等.急性胰腺炎诊治指南[J].中华普通外科学文献:电子版,2015,9(2):86-89.
[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].临床肝胆病杂志,2017,33(11):2052-2057.
[7] Sasaki A,Shiraishi A,Nozaki S,et al.Acute physiology and chronic health evaluation iv probability of mortality is an intermediate variable not a confounder[J].Crit Care Med,2020,48(3):e252-e253.
[8] Trikudanathan G,Wolbrink DR,Santvoort HC,et al.Current concepts in severe acute and necrotizing pancreatitis:An evidence based approach[J].Gastroenterology,2019,156(7):1994-2007.
[9] 刘 静.红细胞分布宽度联合降钙素原检测对急性胰腺炎严重程度及预后评估价值分析[J].陕西医学杂志,2020,49(4):470-473,497.
[10] 李 红,刘俊保,姜艳梅.柴芩承气汤治疗重症急性胰腺炎[J].中医学报,2018,33(12):2454-2457.
[11] 彭 鸿,陈国忠,方丽娇,等.清解化攻法合并高强度综合治疗在重症急性胰腺炎早期的作用[J].辽宁中医杂志,2019,46(5):991-994.
[12] 卢洪军,胡丹萍,厉 兵,等.清胰陷胸汤联合血液净化对重症急性胰腺炎患者临床疗效及免疫功能的影响[J].中国中西医结合外科杂志,2021,27(2):207-211.
[13] 史玉洁,刘静雅,孙光源.清胰汤联合中药外治法对重症急性胰腺炎患者胃肠功能指标、胰腺功能指标的影响[J].中国中医急症,2021,30(8):1450-1453.
[14] 杜高能,蒙绪君.清胰汤治疗重症胰腺炎疗效及对炎症因子的影响[J].山东中医杂志,2019,38(3):238-241.
[15] 冯 芳,齐 艳,董晨明.清胰汤胃管注入联合血必净注射液治疗重症急性胰腺炎80例[J].西部中医药,2019,32(6):98-101.
[16] 徐炎松,宋 凯,尹 冉,等.急性胰腺炎患者血清ApoB/A1、MAP1-LC3和ICAM-1水平在早期病情评估中的价值[J].中华急诊医学杂志,2022,31(4):551-556.
[17] 潘 静,覃月秋,徐晨阳,等.急性胰腺炎患者血清IL-6、IL-10水平变化及其与淋巴细胞自噬凋亡的相关性[J].山东医药,2019,59(27):21-24.
[18] 颜美玲,杨 柳,侯阿娇,等.柴胡化学成分及药理作用研究进展[J].中医药信息,2018,35(5):103-109.
[19] 谭玲玲,胡正海,蔡 霞,等.北柴胡营养器官中主要化学成分的组织化学定位及其含量比较[J].分子细胞生物学报,2007,40(4):214-222.
[20] 董 蕊,逯 影,王 盼.熵权法结合Box-Behnken响应面法优化北柴胡醋炙工艺及其对小鼠肝损伤保护作用研究[J].食品工业科技,2021,42(23):209-217.
[21] 郑寅涛,曹 岗,吴 鑫.山茱萸-白芍酒炙配伍前后通过调节OPG/RANKL/RANK信号通路抗类风湿性关节炎药效机制研究[J].中草药,2022,53(10):3084-3092.
[22] 刘钧菲,刘翠华,厉洪江,等.白芍总苷胶囊联合注射用重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白治疗幼年特发性关节炎23例及对T淋巴细胞免疫、Th1/Th2漂移及红细胞沉降率的影响[J].安徽医药,2020,24(2):381-385.
[23] 张燕丽,田 园,付起凤,等.白芍的化学成分和药理作用研究进展[J].中医药学报,2021,49(2):104-109.
[24] 夏荣华,陈小燕,方慧云,等.黄芩甙抑制儿童全身炎症反应综合征核因子-κB活化及IL-6合成的研究[J].中国民族民间医药,2008,17(3):54-55.
[25] 唐 彬,宋振梅,肖琦凡.黄芩苷对高脂-脂肪肝模型大鼠肝脏炎症改善及炎性因子表达的影响[J].青岛大学医学院学报,2017,53(6):659-663,667.
[26] 陈玉静,陈文强,张建新,等.黄芩甙对慢性脑低灌注大鼠认知功能及其对海马内LC-3Ⅱ和Beclin-1表达的影响[J].首都医科大学学报,2019,40(3):330-334.
[27] 张青玉,郭莲怡,刘宝海.加味清胰汤联合血液灌流治疗高脂血症性重症急性胰腺炎并发肺损伤的疗效[J].中国老年学杂志,2022,42(6):1389-1391.
[28] 尹海娥,黄 玲.清胰汤配合针灸治疗肝郁气滞型急性重症胰腺炎患者的疗效及对血清炎性因子的影响[J].养生大世界,2021,7(6):75.
[29] 房 城,于兴博,郑秀茜,等.黄芩的化学成分及药理作用研究进展[J].化学工程师,2021,5(3):52-54.
[30] 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,2020,41(10):1418-1421.

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备注/Memo

备注/Memo:
基金项目:河北省秦皇岛市科学技术局科研项目(201602A136)
更新日期/Last Update: 2022-09-08