大柴胡汤加减联合醋酸奥曲肽注射液治疗重症急性胰腺炎临床研究

目的 :观察大柴胡汤加减联合醋酸奥曲肽注射液对重症急性胰腺炎(SAP)患者炎性因子、肠道黏膜屏障功能的影响。方法:82例重症急性胰腺炎患者按照入院时间分为观察组、对照组各41例。两组均给予禁食、补液、抗感染等基础治疗,对照组给予醋酸奥曲肽注射液25μg/h,持续静脉泵入,观察组给予大柴胡汤加减联合醋酸奥曲肽注射液治疗。观察患者血清炎性因子、肠道黏膜屏障功能及临床治疗效果。结果:观察组、对照组总有效率分别为95.12%、82.93%,两组比较差异有统计学意义(P0.05);观察组白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、血清肿瘤坏死因子(TNF-α)含量均显著低于对照组,两组比较差异有统计学意义(P0.05);观察组血浆二胺氧化酶(DAO)浓度、尿乳果糖/甘露醇比值(L/M)、血浆内毒素均显著低于对照组(P0.05);观察组腹胀缓解时间、腹痛缓解时间、恶心呕吐消失时间、初次大便时间、住院天数均明显低于对照组(P0.05)。结论:大柴胡汤加减联用醋酸奥曲肽注射液有助于提高SAP患者的治疗效果。

Clinical Study on Modified Dachaihu Decoction Combined with Octreotide Acetate Injection in Treatment of Severe Acute Pancreatitis

Objective:To observe the effects of Dachaihu decoction combined with octreotide acetate injection on the inflammatory factors and intestinal mucosal barrier function in patients with severe acute pancreatitis.Methods:Total 82 patients with severe acute pancreatitis were randomly divided into the observation group and the control group with 41 patients in each group according to the time of admission.Two groups were given fasting,rehydration,anti-inflammatory and other basic treatments.The observation group received Dachaihu decoction combined with octreotide acetate injection treatment while the control group was given octreotide acetate injection 25 μg/h,continuous intravenous pumping.The serum inflammatory factors,intestinal mucosal barrier function and clinical treatment effects were observed.Results:The effective rate of the observation group was 95.12%,significantly higher than that of the control group(82.93%)(P< 0.05).The levels of interleukin-6(IL-6),interleukin-8(IL-8) and serum tumor necrosis factor(TNF-α) in the observation group were significantly lower than those in the control group(P< 0.05).Plasma two amine oxidase(DAO)concentration,lactulose/mannitol ratio(L/M) and endotoxin in the observation group were significantly lower than those in the control group(P< 0.05).Period of time until subsidence of abdominal distension,period of time until subsidence of abdominal pain,period of time until relieving nausea and vomiting,the initial defecation time and the duration of hospitalization in the observation group were significantly lower than those in the control group( P< 0.05).Conclusion :Dachaihu decoction combined with octreotide acetate injection can improve the therapeutic effects.