电针治疗急性胰腺炎及对患者肠道通透性的影响

目的:探讨电针对急性胰腺炎的治疗作用及其机制。方法:将68例急性胰腺炎患者随机分为治疗组(30例)和对照组(38例)。对照组予以抗感染、抑制胰腺分泌、改善微循环、胃黏膜保护剂治疗;治疗组在此基础上予以电针治疗,穴取足三里、上巨虚、公孙、太冲、悬钟,每日2次,共针刺3天。比较两组临床疗效,以及治疗前后内皮素(ET)、一氧化氮(NO)、肿瘤坏死因子(TNF-α)、乳果糖/甘露醇比值(L/M)的变化。结果:治疗组总有效率为86.7%,优于对照组的76.3%(P<0.05)。两组患者治疗后ET、NO、TNF-α、L/M值均高于治疗前,但治疗组的升高幅度均显著低于对照组(P<0.05)。结论:电针可以显著降低急性胰腺炎患者肠黏膜通透性,减少内生性炎性介质(如ET、TNF-α)和血管活性物质(如NO)在肠黏膜的积聚,从而减轻肠上皮细胞的坏死,保护胃肠黏膜屏障。

Electroacupuncture for treatment of acute pancreatitis and its effect on the intestinal permeability of the patient

OBJECTIVE: To probe into effect of electroacupuncture on intestinal permeability in the patient with acute pancreatitis and the mechanism. METHODS: Sixty-eight cases of acute pancreatitis were randomly divided into a treatment group and a control group. The control group and the treatment group were treated with anti-infection, inhibiting secretion of pancreas, improving microcirculation and protective agent of gastric mucosa, with electroacupuncture at Zusanli (ST 36), Shangjuxu (ST 37), Gongsun (SP 4), Taichong (LR 3) and Xuanzhong (GB 39) added, twice daily for 3 days, in the treatment group. Their clinical therapeutic effects and changes of endothelin (ET), nitric oxide (NO), tumor necrosis factor (TNF-alpha) and lactulose/mannose ratio (L/M) before and after treatment were compared. RESULTS: The total effective rate of 86.7% in the treatment group was better than 76.3% in the control group (P < 0.05). After treatment, ET, NO, TNF-alpha contents and L/M all were higher than those before treatment, with those in the treatment group being significantly lower than those in the control group (P < 0.05). CONCLUSION: Electroacupuncture can significantly decrease permeability of intestinal mucosa in the patient with acute pancreatitis, reduce accumulation of endogenous inflammatory mediators (ET, TNF-alpha) and vascular active substance (NO) in intestinal mucosa, so as to alleviate necrosis of intestinal epithelial cells and protect the barrier of gastro-intestinal mucosa.