摘要
目的:观察通腑消涤饮协定方保留灌肠联合血液净化治疗重症急性胰腺炎的临床效果及对患者肠黏膜屏障功能和血清因子的影响。方法:选取重症急性胰腺炎患者56例,按随机数字表法分为对照组和观察组各28例。2组患者均给予常规基础治疗,对照组患者在常规基础治疗上加用连续性血液净化,观察组在对照组基础上给予通腑消涤饮协定方治疗。治疗前后检测2组尿淀粉酶、血清脂肪酶、血清淀粉酶水平,测量小肠黏膜绒毛高度及陷窝深度,监测血清人乳脂球表皮生长因子8(MFG-E8)、D-乳酸、同型半胱氨酸(Hcy)水平。结果:治疗前,2组尿淀粉酶、血清脂肪酶、血清淀粉酶水平比较,差异无统计学意义(P>0.05)。治疗后,2组尿淀粉酶、血清脂肪酶、血清淀粉酶均较治疗前降低,且观察组各项指标均低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组小肠黏膜绒高度、陷窝深度比较,差异无统计学意义(P>0.05)。治疗后,2组小肠黏膜绒高度、陷窝深度较治疗前均有升高,且观察组患者的升高程度高于对照组,差异均有统计学意义(P<0.05)。治疗前,2组MFGE8、D-乳酸、Hcy水平比较,差异无统计学意义(P>0.05)。治疗后,2组MFG-E8水平较治疗前升高,D-乳酸、Hcy水平较治疗前降低;观察组MFG-E8水平高于对照组,D-乳酸、Hcy水平低于对照组;差异均有统计学意义(P<0.05)。结论:通腑消涤饮协定方保留灌肠联合血液净化治疗重症急性胰腺炎效果良好,可有效恢复肠黏膜屏障功能,而调控MFG-E8、D-乳酸、Hcy三者水平是其起效的重要作用机制。
Objective : To observe the clinical effect of retention enema with Tongfu Xiaodi decoction combined with blood purification for severe acute pancreatitis, and its effect on intestinal mucosal barrier function and serum factors of patients. Methods : Selected 56 cases of patients with severe acute pancreatitis, and divided them into the control group and the observation group randomly, 28 cases in each group. Both groups received routine basic treatment, based on which the control group received continuous blood purification, while the observation group additionally received retention enema with Tongfu Xiaodi decoction. Before and after treatment, detected the levels of urine amylase, serum lipase and serum amylase in both groups, measured the height of intestinal villi and the depth of crypts, and monitored the levels of serum milk fat globule epidermal growth factor 8( MFG-E8), D-lactic acid and homocysteine( Hcy). Results : Before treatment, comparing the levels of urine amylase, serum lipase and serum amylase in both groups, there was no significant difference being found( P > 0. 05). After treatment, the levels of urine amylase, serum lipase and serum amylase in both groups were respectively lower than those before treatment, and each index above in the observation group was lower than that in the control group,differences being significant( P < 0. 05). Before treatment, comparing the height of intestinal villi and the depth of crypts in both groups, there was no significant difference being found( P > 0. 05). After treatment, the height of intestinal villi and the depth of crypts in both groups were increased when comparing with those before treatment, and the increasing degree of each index above in the observation group was higher than that in the control group, differences being significant( P <0. 05). Before treatment, comparing the levels of MFG-E8, D-lactic acid and Hcy in both groups, there was no significant difference being found( P > 0. 05). After treatment, the level of MFG-E8 in both groups was h
出处
《新中医》
CAS
2019年第9期102-106,共5页
New Chinese Medicine
