Clinical efficacy of Chaihu Shuyi granule combined with endoscopic retrograde cholangiopancreatography in the treatment of chronic pancreatitis and its influence on the quality of life of patients
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摘要: 目的 探讨柴胡舒胰颗粒联合经内镜逆行胰胆管造影(ERCP)治疗慢性胰腺炎的临床疗效，及对患者症状、生活质量改善的影响。方法 纳入2019年10月—2022年7月收治的64例慢性胰腺炎患者，采用随机对照试验方法，分为对照组和试验组，每组各32例。对照组接受ERCP及内科基础治疗，试验组在对照组基础上联合中药复方柴胡舒胰颗粒治疗，12周为1个疗程。观察2组治疗前后M-ANNHEIM临床特征评分、临床症状评分、生活质量评分及不良反应情况。结果 2组治疗后M-ANNHEIM评分均较治疗前显著下降(P < 0.05)。试验组的临床总有效率(90.6%)显著高于对照组(53.1%)(P < 0.05)。2组治疗后腹痛、腹胀、恶心呕吐、纳差、乏力症状评分较治疗前显著下降(P < 0.05)；且试验组治疗后腹痛、恶心呕吐、便秘、乏力症状评分显著低于对照组(P < 0.05)。2组治疗后生活质量评分均较治疗前显著改善(P < 0.05)；且试验组治疗后生活质量显著优于对照组(P < 0.05)。治疗期间，2组不良反应发生率比较，差异无统计学意义(P>0.05)。结论 柴胡舒胰颗粒联合ERCP治疗慢性胰腺炎能显著提高临床疗效，有效缓解症状并改善生活质量。
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关键词:
- 柴胡舒胰颗粒 /
- 经内镜逆行胰胆管造影 /
- 慢性胰腺炎 /
- 临床疗效 /
- 生活质量
Abstract: Objective The clinical efficacy of Chaihu Shuyi granules combined with endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of chronic pancreatitis was explored, as well as the effect on the improvement of symptoms and quality of life in patients.Methods From October 2019 to July 2022, 64 patients with chronic pancreatitis were enrolled in the study. A randomized controlled trial was conducted to divide the patients into control and experimental group. The control group only received ERCP and basic medical treatment, and the experimental group was additionally treated with Chaihu Shuyi granules, with 32 cases in each group and 12 weeks as a course. Before and after treatment for patients in the two groups, the M-ANNHEIM severity score, clinical symptom score, quality of life score, and the occurrence of adverse events were observed.Results M-ANNHEIM severity score in both groups decreased significantly after treatment compared with before treatment(P < 0.05). The total clinical efficacy in experimental group(90.6%) was significantly higher than that of control group(53.1%)(P < 0.05). The symptom scores of abdominal pain, abdominal distension, nausea or vomiting, poor appetite, and fatigue in both groups after treatment was significantly decreased than those before treatment(P < 0.05). The post-treatment scores of abdominal pain, nausea or vomiting, constipation, and fatigue symptoms in the experimental group decreased more significantly than those of the control group(P < 0.05). Quality of life scores in both groups improved after treatment (P < 0.05); The improvement in quality of life in the experimental group was more obvious than that in the control group(P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups during the treatment(P>0.05).Conclusion Chaihu Shuyi granule combined with ERCP can improve clinical efficacy significantly, relieve symptoms and improve quality of life as well. -
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表 1 2组治疗前后M-ANNHEIM评分比较
分，X±S 组别 例数 治疗前 治疗后 t P 对照组 32 9.34±1.91 7.53±2.16 11.012 < 0.001 试验组 32 9.16±1.72 5.94±1.54 21.880 < 0.001 t 0.412 3.401 P 0.682 0.001 
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表 2 治疗后2组总疗效比较
例 组别 例数 痊愈 有效 无效 总有效率/% Z P 对照组 32 0 17 15 53.1 -3.310 0.001 试验组 32 0 29 3 90.6
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表 3 2组治疗前后症状评分比较
分，M(IQR) 症状 试验组 对照组 Z P 腹痛 治疗前 4.00(2.00) 4.00(2.00) -0.945 0.345 治疗后 01) 2.00(2.00)1) -3.984 0.001 腹胀 治疗前 2.00(2.00) 2.00(0) -1.271 0.204 治疗后 2.00(0)1) 2.00(0)1) -0.811 0.418 恶心呕吐 治疗前 2.00(2.00) 2.00(2.00) -0.337 0.736 治疗后 01) 0(2.00)1) -2.291 0.022 纳差 治疗前 2.00(2.00) 2.00(2.00) -0.302 0.763 治疗后 0(2.00)1) 0(2.00)1) -1.707 0.088 便秘 治疗前 2.00(4.00) 2.00(2.00) -0.187 0.852 治疗后 01) 0(4.00) -2.739 0.006 乏力 治疗前 2.00(2.00) 2.00(2.00) -1.070 0.285 治疗后 0(2.00)1) 2.00(2.00)1) -2.431 0.015 与同组治疗前比较，1)P < 0.05。
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表 4 2组治疗前后生活质量评分比较
分，X±S 项目 时间 试验组 对照组 t/Z P 躯体功能 治疗前 66.67±8.82 67.22±12.54 0.140 0.889 治疗后 90.59±6.691) 82.22±13.731) -2.106 0.043 角色功能 治疗前 61.76±22.64 58.33±15.08 -0.457 0.651 治疗后 93.14±8.451) 73.61±22.981) -2.405 0.024 情绪功能 治疗前 80.88±12.06 77.08±19.50 -0.649 0.522 治疗后 88.24±10.641) 75.69±16.07 -2.220 0.030 认知功能 治疗前 66.67±19.54 65.28±22.98 -0.175 0.862 治疗后 88.24±15.331) 75.00±15.08 -2.235 0.034 社会功能 治疗前 66.67±15.60 65.28±16.60 -0.230 0.820 治疗后 94.12±10.101) 80.56±17.161) -2.398 0.030 总健康状况 治疗前 52.45±9.21 53.47±12.03 0.259 0.797 治疗后 80.39±10.181) 65.28±16.221) -3.087 0.005 与同组治疗前比较，1)P < 0.05
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