清肺承气颗粒对重症急性胰腺炎患者感染期免疫反应的影响

目的 观察清肺承气颗粒对重症急性胰腺炎（SAP）患者感染期免疫反应的影响.方法 将72例确诊为SAP感染期的患者随机分为对照组33例和观察组39例;对照组给予西医常规治疗＋安慰剂,观察组给予西医常规治疗＋清肺承气颗粒,疗程为7d.分别于第1、3、7天,检测患者外周血CD14＋单核细胞人类白细胞抗原DR位点（HLA-DR）、T辅助淋巴细胞1/2（Th1/Th2）、自然调节性T细胞（Treg）.结果 28 d内观察组死亡2例（5.13％）,对照组死亡7例（21.21％）,P ≤0.05.两组第1、3天外周血HLA-DR、Th1/Th2、Treg比较,P均＞0.05.第7天,观察组外周血HLA-DR、Th1/Th2、Treg分别为87.02％±15.94％、5.96 ±6.12、4.58％±3.67％,对照分别为51.01％±33.90％、2.53 ±1.74、8.87％±6.19％;两组比较,P≤0.01、0.05、0.05.结论 清肺承气颗粒可减轻SAP感染期患者免疫抑制、促进免疫恢复,从而降低患者的病死率.

Effects of Qingfei Chengqi granules on immunoreaction in infective stage of patients with severe acute pancreatitis

Objective To observe the effects of Qingfei Chengqi granules on immunoreaction in infective stage of patients with severe acute pancreatitis （SAP）.Methods Seventy-two patients with SAP infection were randomly divided into the control group of 33 cases and the observation group of 39 cases.The control group received conventional Western medicine plus placebo,and the observation group received conventional Western medicine plus Qingfei Chengqi granules.The peripheral blood concentrations of human leukocyte antigen DR site （HLA-DR）,the helper T lymphocyte 1/2 （Th1/Th2）and the regulatory T lymphocyte （Treg） were detected on the 1st,3rd and 7th day.Results Two patients （5.13％） died in the observation group within 28 d while 9 cases （21.21％） died in the control group,P ≤0.05.The peripheral blood HLA-DR,Th1/Th2 and Treg of the two groups had no significant difference on the 1st and 3rd day,all P ＞0.05.On the 7th day,The peripheral blood HLA-DR,Th1/Th2 and Treg in the observation group were 87.02％ ± 15.94％,5.96 ±6.12 and 4.58％ ± 3.67％ while 51.01％ ± 33.90％,2.53 ± 1.74 and 8.87％ ± 6.19％ in the control group,respectively （P≤0.01,P≤0.05 and P≤0.05,respectively）.Conclusion Qingfei Chengqi granules can lighten the immunodepression in infective stage of patients with SAP,enhance the immune recovery and reduce the mortality of SAP.