大黄联合乌司他丁治疗重症急性胰腺炎的研究

目的探讨早期大黄联合应用乌司他丁治疗重症急性胰腺炎患者的疗效及其对血清中细胞因子IL-6、IL-8水平的影响。方法将来自本院住院的患者（57例）分成标准的常规治疗组（18例）、乌司他丁治疗组（19例）及乌司他丁＋大黄治疗组（20例），将本院门诊体检的健康者（16例）作为空白对照。采用放射免疫学法测定其外周血清中IL-6、IL-8水平，并评价各治疗组的病死率、治疗有效率、腹痛腹胀缓解时间和平均住院时间。结果重症急性胰腺炎早期上述细胞因子在患者血清中水平明显升高，经治疗5d后，存活者各组的上述细胞因子水平下降，前后比较差异有统计学意义（P〈0．01）。大黄联用乌司他丁治疗后存活者的腹痛腹胀缓解时间、平均住院时间较其它两组缩短，治疗有效率增高（P〈0．05），但3种治疗方法的病死率差异无统计学意义（P〉0．05）；机体细胞因子IL-6、IL-8水平迅速下降，较常规治疗及乌司他丁治疗组下降水平更明显，结果相比差异有统计学意义（P〈0．01）。结论早期大黄联用乌司他丁治疗重症急性胰腺炎患者．有利于提高治疗效果。

The Study of Rhubarb and Ulinastatin Combined Treatment of Severe Acute Pancreatitis

Objective To explore the effects of Rhubarb combined with Ulinastatin on severe acute pancreatitis paitents and their roles to serum levels of IL-6 and IL-8. Method 57 patients with severe acute pancreatitis were divided into three groups. On the base of normal therapy, paitents are treated with Rhubarb plus Ulinastatin in group 1 （Rhubarb ＋ Ulinastatin group, n=20）, only by Ulinastatin in group 2 （Ulinastatin group, n=19）, and only by normal treatment（normal treatment group, n= 18）. 16 healthy people from clinic were selected as blank control（blank group, n=16）. The serum levels of IL-6 and IL-8 were detected by radioimmunology. The clinical index,including case fatality, effective power, catabatic duration of abdominal pain, amylase＇s coincidnece time and average stay time, were observed. Result Serum levels of IL-6 and IL-8 increased sharply in severe acute pancreatitis patients, which were higher than those in blank control group （P〈0.01）. Their level decreased obviously after 5 days of all treatment group. The statistics difference was significant （P〈0.05）. The clinical index of survivor in Rhubarb ＋ Ulinastatin group was better than the other group （P〈0.05）. No significant difference in fatality rate could be observed among the three groups. And the levels of IL-6 and IL-8 were lower in Rhubarb ＋ Ulinastatin group than those in other groups （P〈0.05）. Conclusion Maybe the combination of Rhubarb and Ulinastatin is helpful to patients to recover from severe acute in early stage.