清胰汤治疗胆源性急性胰腺炎术后临床研究

目的:观察清胰汤治疗胆源性急性胰腺炎经内镜逆行胆胰管造影术(ERCP)术后的康复效果。方法:将胆源性急性胰腺炎患者190例,按随机数字表法分为对照组与试验组各95例。2组均择期行ERCP手术治疗,对照组手术前后给予生长抑素治疗,试验组在对照组的基础上联合清胰汤治疗。观察2组术后血清淀粉酶(AMS)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)水平变化;比较2组淋巴细胞(LYM)计数及其亚群等免疫细胞的变化,以及住院时间、术后并发症发生率情况。结果:术后7 d,2组AMS、CRP、IL-6水平均较术后2 h降低(P<0.05),且试验组低于对照组(P<0.05)。术后7 d,LYM及CD4⁺水平均高于术前(P<0.05),CD8⁺低于术前(P<0.05);且试验组LYM及CD4⁺均高于对照组(P<0.05),CD8⁺低于对照组(P<0.05)。治疗后,试验组平均住院时间短于对照组(P<0.05),并发症发生率低于对照组(P<0.05)。结论:清胰汤能显著减少胰腺炎ERCP术后炎症反应,促进术后康复。

Clinical Study on Qingyi Tang for Biliary Acute Pancreatitis After Endoscopic Retrograde Cholangiopancreatography

Objective:To observe the rehabilitation effect of Qingyi tang for biliary acute pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP). Methods:A total of 190 cases of patients with biliary acute pancreatitis were divided into the control group and the experiment group according to the random number table method, 95 cases in each group. Both groups were treated with selective ERCP. Before and after surgery, the control group was treated with somatostatin, and the experiment group was additionally treated with Qingyi tang based on the treatment of the control group. The changes in the levels of amylase(AMS), C-reactive protein(CRP) and interleukin-6(IL-6) in serum in the two groups after surgery were observed;the changes of immune cells including lymphocytes and their subsets,the length of hospital stay and the incidence of postoperative complications in the two groups were compared. Results:On the 7 th day after surgery,the values of AMS,CRP and IL-6 in the two groups were all decreased when compared with those at two hours after surgery(P<0.05),and the values in the experiment group were lower than those in the control group(P<0.05). On the7 thday after surgery,the values of LYM and CD4⁺cells were higher than those before surgery(P<0.05),and CD8⁺values were lower(P<0.05);the values of LYM and CD4⁺in the experiment group were higher than those in the control group(P<0.05),and CD8⁺value was lower(P<0.05). After treatment,the average length of hospital stay in the experiment group was shorter than that in the control group(P<0.05);the incidence of complications was lower than that in the control group(P<0.05). Conclusion:Qingyi tang can significantly reduce the inflammatory responses after ERCP for pancreatitis and promote postoperative rehabilitation.