中药清胰汤对ERCP术后胰腺炎预防作用的探讨

目的:探讨中药清胰汤能否预防经内镜逆行胆胰管造影(ERCP)术后胰腺炎及可能的作用机制。方法:将102例需行ERCP术的患者术前随机平分为试验组和对照组,术前2h试验组予清胰汤水煎剂口服,对照组预同量的生理盐水口服。两组患者分别在术前2h、术后2h和术后24h抽血检测淀粉酶、C反应蛋白和IL-6含量,比较它们在两组之间的差异。结果:术后出现胰腺炎5例(4.9%),均为轻症胰腺炎,试验组2例,对照组3例,差异无统计学意义;高淀粉酶血症总数为34例(33.3%),试验组15例,对照组19例,差异无统计学意义。试验组和对照组的术前2h血淀粉酶、C反应蛋白及IL-6无明显差异,术后2h、24h血淀粉酶、C反应蛋白及IL-6的数值均进行性升高,试验组均低于对照组。试验组和对照组的术后24h的C反应蛋白、IL-6差异有统计学意义(P0.05)。结论:中药清胰汤能减轻ERCP术后的全身炎症反应。

Discussion on Prevention Effect of Qingyi Decoction on Pancreatitis after ERCP

Objective:To investigate the prevention on pancreatitis after the operation of ERCP with the help of traditional Chinese medicine Qingyi Decoction.Methods:Before the operation of ERCP,patients were assigned into the experiment group(n=51)and the control group(n=51)randomly.The patients in the experiment group were given Qingyi Decoction orally 2 hours before the operation.The patients in the control group were given physiological salt solution equally.The serum levels of Amylase,C-creative protein and IL-6 in all the patients were measured 2 hours before the operation,2 hours and 24 hours after the operation respectively.Results:After the operation,5 cases of acute pancreatitis occurred(2 cases in the experiment group and 3 cases in the control group)and they were all mild.The occurrence rates in two groups had no significance.34 cases of high serum level of Amylase occurred(15 cases in the experiment group and 19 cases in the control group).The occurrence rates in two groups had no significance.The serum levels of Amylase,C-creative protein and IL-6 had no significance 2 hours before the operation in two groups.The serum levels of Amylase,C-creative protein and IL-6 continued to rise 2 and 24 hours after the operation in two groups and the serum levels of the experiment group were lower than those of the control group respectively.The serum levels of C-creative protein and IL-6 in the control group were significantly higher than those in the experiment group(P<0.05).Conclusion:Traditional Chinese medicine Qingyi Decoction can reduce the reaction of inflammation.