清胰汤联合肠内营养对重症急性胰腺炎炎症因子平衡状态的影响

目的研究清胰汤联合肠内营养对重症急性胰腺炎炎症因子水平和肠道功能恢复的影响。方法将129例重症急性胰腺炎病人随机分为研究组(66例)和对照组(63例)。对照组行胃肠减压、补液、抗生素、抑制胰腺分泌等治疗,研究组在此基础上加用清胰汤鼻饲,肠功能恢复后开始肠内营养。分别观察两组病人腹胀消退时间、禁食时间、胰周感染率,血淀粉酶、IL-8、IL-10、TNF-α、血浆白蛋白、前白蛋白等临床指标并加以比较。结果研究组血淀粉酶水平自鼻饲清胰汤后第3天开始显著下降,血清IL-8和TNF-α水平第5天出现显著下降,且第3、5、7天血淀粉酶、血清TNF-α水平较对照组显著降低,两组间差异均有统计学意义(P0.05);治疗后第5、7天病人血清IL-8水平较对照组显著降低,IL-10水平较治疗前显著升高,两组间上述两指标比较,差异均有统计学意义(P0.05)。结论清胰汤能有效促进肠道功能恢复,维持炎症因子平衡状态。

The effects of Qing Yi decoction in combination with enteral nutrition on inflammatory cytokine balance of patients with severe acute pancreatitis

Objective To study the effects of Chinese medicine Qing Yi Tang combined with enteral nutrition on the clinical outcomes and changes of blood IL-8, IL-10, TNF-a in patients with severe acute pancreatitis（SAP）. Methods 129 cases of SAP were randomly divided into two groups： control group （n = 63）and the experimental group（n = 66）. Routine treatments were given in both groups, and Qing Yi Tang combined with enteral nutrition was given in the experimental group additionally. The clinical outcomes, the serum levels of IL-8, IL-10, TNF-α and the serum albumin, preal- bumin were observed. Results The clinical outcomes in experimental groups were significantly improved as compared with control group. The levels of IL-8 and TNF-α in serum in experimental group were significantly lower than in control group at the same time point（P〈0. 05）,and decreased more obviously as the time went on in experimental group at the same time point（P〈0. 05）. In experimental groups the level of IL-10 in serum was higher than in control group. The patients receiving Qing Yi Tang also had significantly higher serum albumin and prealbumin levels with shorter hospital stay than in control group（P〈0.05）. Conclusion The Chinese medicine Qing Yi Tang can effectively promote the recovery of intestinal function, and maintain the balance of proand anti-inflammatory cytokines.