摘要
目的 探讨柴芩承气汤联合乌司他丁、奥曲肽治疗对急性重症胰腺炎(SAP)患者疗效、临床症状改善、氧化应激指标、炎性因子指标的影响.方法 选取我院2019年4月至2021年4月收治的SAP患者102例,采用根据采用的治疗方案不同,分为常规西药组(51例)和中药辅助组(51例).常规西药组在对症支持治疗的基础上,采用西药乌司他丁、奥曲肽治疗,中药辅助组在常规西药组治疗的基础上,采用柴芩承气汤辅助治疗.对比两组临床疗效、症状改善情况(血淀粉酶、体温、腹痛、肠功能)、治疗前后氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH)、活性氧(ROS)]炎性因子指标[闭合蛋白、肿瘤坏死因子-α(TNF-α)、白细胞介素-18(IL-18)、IL-6].结果 中药辅助组总有效率(94.12％)高于常规西药组(78.43％)(P＜0.05);中药辅助组腹痛缓解时间、体温恢复正常时间、血淀粉酶恢复正常时间、肠功能恢复时间均短于常规西药组(P＜0.05);与治疗前比较,治疗14 d后两组SOD、ROS水平均升高,MDA、GSH水平均降低,且中药辅助组SOD、MDA、GSH、ROS改善程度大于常规西药组(P＜0.05).与治疗前比较,治疗14 d后两组闭合蛋白水平均升高,TNF-α、IL-18、IL-6水平均降低,且中药辅助组闭合蛋白、TNF-α、IL-18、IL-6水平改善程度大于常规西药组(P＜0.05).结论 柴芩承气汤辅助乌司他丁、奥曲肽治疗SAP的疗效确切,可改善SAP患者的临床症状,可减轻机体的氧化应激程度和炎性反应,具有一定的安全性.
Abstract
Objective To explore the effect of Chaiqin Chengqi decoction combined with ulinastatin and octreotide on the curative effect,clinical symptom improvement,oxidative stress index and inflammatory factor index of patients with se-vere acute pancreatitis(SAP).Methods 102 SAP patients admitted in our hospital from April 2019 to April 2021 were se-lected and divided into conventional western medicine group(51 cases)and TCM auxiliary group(51 cases)according to the different treatment schemes.On the basis of symptomatic support treatment,the conventional western medicine group was treated with western medicine ulinastatin and octreotide,while the TCM auxiliary group was treated with Chaiqin Chengqi decoction on the basis of conventional western medicine group.The clinical efficacy,symptom improvement(blood amylase,body temperature,abdominal pain,intestinal function),indicators of oxidative stress[superoxide dismutase(SOD),malondi-aldehyde(MDA),glutathione peroxidase(GSH),reactive oxygen species(ROS)],indicators of inflammatory factors[clo-sure protein,tumor necrosis factor-α(TNF-α),Interleukin-18(IL-18),IL-6]were compared between conventional western medicine grou and TCM auxiliary group.Results The total effective rate of the TCM auxiliary group(94.12％)was higher than that of the conventional western medicine group(78.43％)(P＜0.05).The relieving time of abdominal pain,the time of body temperature returning to normal,the time of blood amylase returning to normal,and the time of intestinal function re-covery in the TCM auxiliary group were shorter than those in the conventional western medicine group(P＜0.05).Com-pared with before treatment,the levels of SOD and ROS in both groups were increased,while the levels of MDA and GSH were decreased after 14 days of treatment;after 14 days of treatment,the improvement degree of SOD,MDA,GSH and ROS in the TCM auxiliary group was greater than that in the conventional western medicine group(P＜0.05).Compared with be-fore treatment,the level of closure protein in both groups was increased,the levels of TNF-α,IL-18 and IL-6 water decreased after 14 days of treatment;after 14 days of treatment,the improvement degree of closure protein,TNF-α,IL-18 and IL-6 in the TCM auxiliary group was greater than that in the conventional western medicine group(P＜0.05).Conclusion Chaiqin Chengqi decoction is effective in assisting ulinastatin and octreotide in the treatment of SAP,which can improve the clinical symptoms of SAP patients,reduce the degree of oxidative stress and inflammatory reaction of the body,and has cer-tain safety.
维普
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