大承气汤治疗轻度急性胰腺炎的临床效果及其对肠黏膜屏障的影响

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摘要目的探讨大承气汤治疗轻度急性胰腺炎（MAP）的临床效果及对患者肠道黏膜屏障的影响。方法选取2017年1月—2018年12月深圳市罗湖区人民医院和龙华区人民医院收治的60 例MAP 患者作为研究对象，按照随机数字表法分为对照组（30 例）与实验组（30 例）。对照组采用常规西医方法治疗，实验组在对照组基础上联合大承气汤治疗。比较两组的临床治疗效果、临床指标、肠黏膜屏障损伤指标、炎症因子指标及不良反应发生情况。结果实验组治疗总有效率高于对照组，差异有统计学意义（P＜0.05）。实验组的腹痛、腹胀消失时间、肠鸣音恢复时间、首次排便时间及住院时间均短于对照组，差异有统计学意义（P＜0.05）。治疗前两组的肠黏膜屏障损伤指标比较，差异无统计学意义（P＞0.05）；治疗3、5 d 后实验组的血清肠型脂肪酸结合蛋白、D-乳酸水平均低于对照组，差异有统计学意义（P＜0.05）。治疗前两组患者的炎症因子指标比较，差异无统计学意义（P＞0.05）；治疗3、5 d后，实验组的的血淀粉酶、C-反应蛋白、白介素-6 水平均低于对照组，差异有统计学意义（P＜0.05）。两组的不良反应发生情况比较，差异无统计学意义（P＞0.05）。结论在常规治疗MAP 的基础上加用大承气汤可明显提高疗效，修复肠道黏膜屏障，抑制炎症因子。

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关键词 ：大承气汤, 轻度急性胰腺炎, 肠道黏膜屏障, 肠型脂肪酸结合蛋白, D-乳酸, 白介素-6

Abstract：Objective To investigate the clinical effect of Dachengqi Decoction in the treatment of mild acute pancreatitis (MAP) and its effect on intestinal mucosal barrier. Methods A total of 60 MAP patients admitted to Shenzhen Luohu District People′s Hospital and Longhua District People′s Hospital from January 2017 to December 2018 were selected as the research subjects and divided into control group (30 cases) and experimental group (30 cases) according to random number table method. The control group was treated with conventional Western medicine and the experimental group was treated with Dachengqi Decoction on the basis of the control group. The clinical treatment effect, clinical indicators, intestinal mucosal barrier injury indexes, inflammatory factors and the incidence of adverse reactions were compared between the two groups. Results The total effective rate of the experimental group was higher than that of the control group, the difference was statistically significant (P＜0.05). The disappearance time of abdominal pain and abdominal distension, the recovery time of intestinal sounds, the first defecation time and the hospital stay in the experimental group were all shorter than those in the control group, the differences were statistically significant (P＜0.05). Before treatment, there were no significant differences in intestinal mucosal barrier injury indexes between the two groups(P＞0.05). After 3 and 5 days of treatment, the serum levels of intestinal fatty acid binding protein and D-lactic acid in the experimental group were lower than those in the control group, the differences were statistically significant (P＜0.05).Before treatment, there were no significant differences in inflammatory cytokines between two groups (P＞0.05). After 3 and 5 days of treatment, the levels of blood amylase, C-reactive protein and interleukin-6 in the experimental group were all lower than those in the control group, the differences were statistically significant (P＜0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P＞0.05). Conclusion The addition of Dachengqi Decoction on the basis of the conventional treatment of MAP can significantly improve the curative effect, repair the intestinal mucosal barrier and inhibit inflammatory factors.

Key words： Dachengqi Decoction Mild acute pancreatitis Intestinal mucosa barrier Intestinal fatty acid binding protein D-lactate Interleukin-6

收稿日期: 2021-03-04

基金资助:广东医科大学校院联合科研基金项目（L2016011）

引用本文:

王红芳；申建刚；李俊达；叶石才；黄锦文；邱嘉华；黄敏；杨驰. 大承气汤治疗轻度急性胰腺炎的临床效果及其对肠黏膜屏障的影响[J]. 中国当代医药, 2021, 28(19): 16-19转24.
WANG Hong-fang1 SHEN Jian-gang2▲ LI Jun-da2 YE Shi-cai3 HUANG Jin-wen2 QIU Jia-hua2 HUANG Min2 YANG Chi2. Clinical effect of Dachengqi Decoction in the treatment of mild acute pancreatitis and its effect on intestinal mucosal barrier. 中国当代医药, 2021, 28(19): 16-19转24.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I19/16

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