大承气汤联合西医治疗重症急性胰腺炎的疗效及其对肠黏膜屏蔽功能的影响

钟雄利; 谭小燕; 任伟旺; 许超贵

doi:10.3969/j.issn.1671-038X.2015.04.05

大承气汤联合西医治疗重症急性胰腺炎的疗效及其对肠黏膜屏蔽功能的影响

- 广东省茂名市人民医院消化二科, 广东茂名 525000

详细信息

作者简介:
钟雄利,主治医师,本科,研究方向:消化内科

通讯作者: 钟雄利,E-mail:64165142@qq.com

中图分类号: R657.51

收稿日期: 2014-11-06

Clinical effect of Dachengqi decoction combined with western medicine on intestinal barrier function in the treatment of severe acute pancreatitis

- Department of Gastroenterology, The People Hospital of Mao Ming, Mao Ming 525000, China

More Information

Corresponding author: ZHONG Xiong-li, E-mail: 64165142@qq.com

Received Date: 06 November 2014

摘要

摘要: [目的]考察大承气汤联合西医治疗重症急性胰腺炎（SAP）的疗效及其对肠黏膜屏蔽功能的影响。[方法]将入院治疗的SAP患者80例随机分为研究组和对照组，每组各40例。对照组给予常规西医内科治疗，研究组在此基础上给予大承气汤治疗，比较2组患者治疗1周后症状和体征、腹内压力（IAP）、免疫球蛋白A （IgA）、白细胞介素6（IL-6）及二胺氧化酶（DAO）的变化。[结果]治疗1周后研究组阳性症状和阳性体征率分别为40.0%和35.0%，均显著低于对照组的75.0%和70.0%（P<0.05）。治疗前2组IAP、DAO、IL-6和IgA差异无统计学意义。治疗1周后，2组IAP、DAO、IL-6和IgA均显著降低（P<0.05），但研究组IAP、DAO、IL-6和IgA均显著低于对照组（P<0.05）。[结论]大承气汤联合西医可以有效改善SAP患者的临床症状，有利于肠黏膜屏蔽功能恢复和调节炎症免疫反应，具有临床应用价值。
- 重症急性胰腺炎 /
- 大承气汤 /
- 肠黏膜 /
- 屏蔽功能
Abstract: [Objective] To evaluate the clinical efficacy of Dachengqi decoction combined with western medicine on intestinal barrier function in the treatment of severe acute pancreatitis(SAP).[Methods] A total of 80 patients with SAP were randomly divided into study group and control group, with 40 patients in each group.Patients in control group were treated by routine western medicine therapy.Patients in research group were treated by Dachengqi decoction.The symptoms and signs, abdominal pressure, DAO, IL-6, and IgA were compared between the two groups.[Results] After treatment for a week, the rate of positive symptoms and signs was 40.0% and 35.0% in research group, which was lower than that of 75.0% and 70.0% in control group(P<0.05).Before treatment, IAP, DAO, IL-6, and IgA was no significant difference between the two groups.Which was all decreased in the two groups(P<0.05).Which was lower in research group than that in control group(P<0.05).[Conclusion] Dachengqi decoction combined with western medicine can effectively improve the clinical symptoms of patients with SAP, and which was conducive to recovery intestinal mucosa barrier function and regulate inflammatory immune response. It had clinical value.
- severe acute pancreatitis /
- Dachengqi decoction /
- intestinal mucosa /
- barrier function

HTML全文

参考文献(13)

[1]	邢正云, 顾伟, 吴丽芳.连续血液净化疗法在重症急性胰腺炎中的应用[J].安徽医学, 2011, 32(3):314-316.
[2]	陈凡, 戴义娟, 洪瑞玲, 等.C反应蛋白及血细胞比容检测在预测重症急性胰腺炎中的临床价值[J].安徽医学, 2011, 32(6):733-735.
[3]	TALUKDAR R, VEGE S S.Early management of severe acute pancreatitis[J].Current Gastroenterology Reports, 2011, 13:123-130.
[4]	BRISINDA G, VANELLA S, CROCCO A, et al.Severe acute pancreatitis:advances and insights in assessment of severity and management[J].European Journal of Gastroenterology & Hepatology, 2011, 23:541-551.
[5]	WITTAU M, MAYER B, SCHEELE J, et al.Systematic review and meta-analysis of antibiotic prophylaxis in severe acute pancreatitis[J].Scandinavian Journal of Gastroenterology, 2011, 46:261-270.
[6]	李贺, 项和平.急性重症胰腺炎治疗进展[J].安徽医学, 2010, 31(11):1381-1382.
[7]	张大鹏, 崔乃强, 李岩, 等.重症急性胰腺炎中西医结合治疗自然病程观察[J].中国中西医结合外科杂志, 2011, 17(3):235-239.
[8]	张圣道, 雷若庆.重症急性胰腺炎诊治指南[J].中华外科杂志, 2007, 45(11):727-729.
[9]	KE L, NI H, SUN J, et al.Risk factors and outcome of intra-abdominal hypertension in patients with severe acute pancreatitis[J].World Journal of Surgery, 2012, 36:171-178.
[10]	程君涛, 李小毅, 冯智, 等.腹内高压对肠黏膜氧化还原状态的影响[J].世界华人消化杂志, 2009, 17(26):2673-2678.
[11]	马安新.重症急性胰腺炎肠屏障功能障碍的相关研究[J].医学理论与实践, 2014, 27(16):2165-2166.
[12]	邹劲林, 李振东, 袁琦文.大承气汤联合针灸治疗对腹部手术后肠道功能恢复的影响[J].中国中西医结合急救杂志, 2011, 18(3):152-154.
[13]	余秀文, 杨润芝.大黄对重症急性胰腺炎患者血清IL-15、IL-18影响的研究[J].安徽医学, 2013, 34(3):285-287.