摘要
目的:探讨柴芍承气汤治疗腑实热结型中重度急性胰腺炎的疗效和对炎症反应的影响,为临床治疗和预后评价提供新思路。方法:选取腑实热结型中重度急性胰腺炎患者60例为研究对象,随机分为常规治疗的对照组和常规治疗联合柴芍承气汤治疗的治疗组,均治疗2周。对比两组临床疗效和中医证候的差异,记录治疗前后Ranson评分、Balthazar CTSI评分、SIRS评分、改良Marshall评分的变化,比较治疗前后炎症因子和氧化应激相关分子的水平。结果:治疗后,对照组和治疗组临床疗效总有效率分别为80.0%和93.3%,差异具有统计学意义(χ2=8.845,P=0.027);治疗后,对照组和治疗组中医证候评价总有效率分别为76.7%和93.3%,差异具有统计学意义(χ2=10.024,P=0.012);治疗后,两组Ranson评分、Balthazar CTSI评分、SIRS评分、改良Marshall评分均显著降低(P<0.05),且治疗组降低幅度更大(P<0.05);治疗后,两组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和丙二醛(MDA)均显著降低,超氧化物歧化酶(SOD)显著升高(P<0.05),且治疗组改善程度更大(P<0.05)。结论:柴芍承气汤对腑实热结型中重度急性胰腺炎具有较好的疗效,可有效改善炎症反应和氧化应激,具有较高的临床推广意义。
Objective:To explore the curative effect of ChaishaoChengqi Decoction on moderate to severe acute pancreatitis of heat stagnation and Fu-organ excess type and its effect on inflammatory reaction,and to provide new ideas for clinical treatment and prognosis evaluation.Methods:A total of 60 patients with moderate to severe acute pancreatitis of heat stagnation and Fu-organ excess type from June 2017 to June 2019 were randomly divided into the control group treated with conventional therapy and the treatment group treated with ChaishaoChengqi Decoction based on conventional therapy for 2 weeks.The differences of in clinical efficacy and TCM syndromes between the two groups were compared.Ranson score,Balthazar CTSI score,SIRS score and modified Marshall score were recorded before and after treatment.The levels of inflammatory factors and oxidative stress-related molecules were compared before and after treatment.Results:After treatment,the total effective rates of the control group and the treatment group were 80.0%and 93.3%,respectively,with statistical difference(χ2=8.845,P=0.027);after treatment,the total effective rates of TCM syndromes evaluation of the control group and the treatment group were 76.7%and 93.3%,respectively,with statistical difference(χ2=10.024,P=0.012);after treatment,the Ranson score,Balthazar CTSI score,SIRS score and improved Marshall score were all significantly decreased(P<0.05),and the decrease was more significant in the treatment group(P<0.05);after treatment,the serum levels of TNF-α,IL-6 and MDA were significantly decreased in both groups,and superoxide dismutase(SOD)was significantly increased(P<0.05),and the treatment group improved more(P<0.05).Conclusion:ChaishaoChengqi Decoction has a good curative effect on moderate to severe acute pancreatitis of heat stagnation and Fu-organ excess type,and can effectively improve inflammatory response and oxidative stress,which has a high clinical significance.
作者
曹静静
张春雨
王晓瑜
CAO Jing-Jing;ZHANG Chun-yu;WANG Xiao-yu(Department of Spleen and Stomach Diseases,Zhangjiagang Hospital of Traditional Chinese Medicine,Zhangjiagang 215600,China)
出处
《海南医学院学报》
CAS
2020年第3期194-198,共5页
Journal of Hainan Medical University
基金
2018年张家港市卫计委系统青年科技项目(ZJGQNLKJ201813)~~
关键词
柴芍承气汤
中重度急性胰腺炎
炎症反应
预后
ChaishaoChengqi Decoction
Moderate to severe acute pancreatitis
InflammatoryResponseresponse
Prognosis
