胰胆舒胶囊联合胰管空肠侧侧吻合术治疗老年慢性胰腺炎伴胰管扩张临床研究

目的 评价胰胆舒胶囊联合胰管空肠侧侧吻合术治疗老年慢性胰腺炎伴胰管扩张疗效.方法 将符合入选标准的84例老年慢性胰腺炎伴胰管扩张患者采用随机数字表法分为2组,每组42例.对照组行胰管空肠侧侧吻合术治疗,观察组在对照组基础上口服胰胆舒胶囊治疗.采用Izbicki评分系统评价患者临床症状,采用EORTC-QLQ-C30评分系统评价患者生活质量,检测治疗前后患者血清炎性细胞因子水平,评价临床疗效.结果 观察组总有效率为92.8%(39/42)、对照组为76.2%(32/42),2组比较差异有统计学意义(Z=3.561,P=0.040).治疗后,观察组腹痛(0.4±0.1)分比(1.3±0.2)分,t=3.672]、恶心呕吐(0.3±0.0)分比(1.0±0.1)分,t=4.001]、腹胀(1.2±0.1)分比(2.0±0.2)分,t=3.752]、乏力(0.4±0.1)分比(1.4±0.1)分,t=4.282]评分低于对照组(P<0.05);观察组角色功能(87.4±9.1)分比(70.6±7.0)分,t=3.459]、躯体功能(70.5±7.2)分比(61.5±6.2)分,t=4.316]、情绪功能(79.1±7.7)分比(65.8±6.3)分,t=3.671]、社交功能(80.3±8.1)分比(69.1±6.2)分,t=3.773]评分高于对照组(P<0.05);观察组血清TNF-α(0.71±0.13)ng/ml比(1.02±0.15)ng/ml,t=3.652]、IL-8(1.94±0.1)ng/ml比(4.51±0.54)ng/ml,t=3.367]、hs-CRP(1.01±0.14)mg/L比(2.15±0.29)mg/L,t=3.701]水平低于对照组(P<0.05).结论 胰胆舒胶囊联合胰管空肠侧侧吻合术可提高老年慢性胰腺炎伴胰管扩张患者临床疗效,缓解临床症状及炎症反应,提高生活质量.

The efficacy of Yidanshu capsule combined with pancreatic duct jejunum anastomosis for elderly chronic pancreatitis with pancreatic duct dilatation

Objective Evaluation of the effect ofYidanshu capsule combined with pancreatic duct jejunum anastomosis (Frey procedure) for elderly chronic pancreatitis with pancreatic duct dilatation.Methods A total of 84 patients with dysphagia after stroke who met the inclusion criteria were divided into 2 groups, 42 in each. Both groups were treated with frey procedure, and the observation group addedYidanshu capsule. Izbicki grading system was used to evaluate patients' clinical symptoms, the EORTC-QLQ-C30 scoring system to evaluate patients' quality of life. The serum levels of inflammatory cytokines was also used to evaluate the clinical efficacy. Results The total effective rate of observation group was 92.8% (39/42), and the control group was 76.2% (32/42). The difference was statistically significant (Z=3.561,P=3.561). After treatment, abdominal pain (0.4 ± 0.1 vs. 1.3 ± 0.2,t=3.672), nausea and vomiting (0.3 ± 0.0vs. 1.0 ± 0.1,t=4.001), Abdominal distension (1.2 ± 0.1vs. 2.0 ± 0.2,t=3.752), weak (0.4 ± 0.1vs. 1.4 ± 0.1,t=4.282) scores in the observation group were significantly lower than the control group (P<0.05). The role function (87.4 ± 9.1vs.70.6 ± 7.0,t=3.459), the body function (70.5 ± 7.2vs. 61.5 ± 6.2,t=4.316), emotional function (79.1 ± 7.7vs. 65.8 ± 6.3,t=3.671), social function (80.3 ± 8.1vs. 69.1 ± 6.2,t=3.773) scores in the observation group were significantly higher than the control group (P<0.05). The serum TNF-α (0.71 ± 0.13 ng/mlvs. 1.02 ± 0.15 ng/ml,t=3.652), IL-8 (1.94 ± 0.1 ng/mlvs. 4.51 ± 0.54 ng/ml,t=3.367), hs-CRP (1.01 ± 0.14 mg/Lvs.2.15 ± 0.29 mg/L,t=3.701) levels in the observation group were significantly lower than the control group (P<0.05).Conclusions TheYidanshu capsule combined with pancreatic duct jejunum anastomosis can improve the clinical curative effect of elderly patients with chronic pancreatitis with pancreatic duct expansion, relieve the clinical symptoms and inflammation, and improve the quality of life.