文章摘要
清胰陷胸汤对重症急性胰腺炎合并急性肺损伤患者炎性因子及免疫功能的影响
Effects of Qingyi Xianxiong Decoction on inflammatory factors and immune function in patients with severe acute pancreatitis complicated with acute lung injury
投稿时间:2020-12-27  修订日期:2021-04-07
DOI:
中文关键词: 清胰陷胸汤  重症急性胰腺炎  急性肺损伤  炎性因子  免疫功能
英文关键词: 
基金项目:山东省中医药科技发展计划项目(2019-0809)通讯作者△Corresponding author,E-mail:564334007@qq.com
作者单位邮编
卢洪军 山东省日照市中医医院重症医学科 山东日照 276800 276800
胡丹萍 山东省日照市中医医院重症医学科 山东日照 276800 
厉 兵 山东省日照市中医医院重症医学科 山东日照 276800 
闫培清△ 山东省日照市中医医院重症医学科 山东日照 276800 
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中文摘要:
      目的:探讨清胰陷胸汤对重症急性胰腺炎(SAP)合并急性肺损伤患者炎性因子及免疫功能的影响。方法:选取SAP合并急性肺损伤患者70例,随机分为观察组与对照组,各35例。对照组给予常规西医治疗,包括胃肠减压/禁食、抗感染、抑酸、抑制腺体分泌、维持水/电解质平衡、营养支持治疗,必要时给予经口气管插管机械通气。观察组在对照组治疗基础上,同时应用中药清胰陷胸汤,一煎经胃管或者空肠营养管注入,二煎经直肠注入。两组持续治疗14天。观察比较两组患者的临床症状体征缓解时间、动脉血气分析、急性生理与慢性健康评分、血清炎性因子水平和T淋巴细胞亚群水平变化。结果:两组治疗14d后,观察组患者腹痛腹胀缓解时间、呼吸困难缓解时间、肠鸣音恢复时间、ICU平均住院时间,较对照组明显缩短,差异具有统计学意义(P<0.05)。两组患者PaO2、氧合指数均较治疗前升高,且观察组高于对照组,差异有统计学意义(均P< 0.05)。两组患者APACHEII评分较治疗前降低,且观察组低于对照组,差异有统计学意义(P< 0.05)。两组患者TNF-α、IL-6、CRP水平均较治疗前降低,且观察组低于对照组,差异有统计学意义(均P< 0.05)。两组患者CD3+、CD4+、CD8+水平均较治疗前升高,且观察组高于对照组,差异有统计学意义(均P< 0.05)。两组总有效率比较,观察组明显高于对照组,差异有统计学意义(P< 0.05)。结论:清胰陷胸汤能够减轻SAP患者腹胀、腹痛等临床症状,恢复胃肠功能,减轻SAP患者肺损伤,减轻全身炎症反应,恢复机体免疫状态平衡状态。
英文摘要:
      Objective To discuss the effect of Qingyixianxiong Decoction on inflammatory factors and immune function in patients with severe acute pancreatitis (SAP) complicated with acute lung injury. Methods 70 patients were randomly divided into observation group and control group, 35 cases in each group. The control group was given routine treatment, including gastrointestinal decompression / fasting, anti infection, acid suppression, gland secretion inhibition, water / electrolyte balance maintenance, nutritional support treatment, and oral tracheal intubation mechanical ventilation if necessary. On the basis of the treatment of the control group, the observation group on the basis of the control group, at the same time, the traditional Chinese medicine Qingyixianxiong decoction was applied, the first decoction was injected through the stomach tube or jejunum nutrition tube, and the second decoction was injected through the rectum. The two groups were treated for 14 days. The remission time of clinical symptoms and signs, arterial blood gas analysis, acute physiology and chronic health score, serum levels of inflammatory factors and T lymphocyte subsets were observed and compared between the two groups. Results After 14 days of treatment, the relief time of abdominal pain, abdominal distension, dyspnea, bowel sounds recovery and average ICU hospital stay in the observation group were significantly shorter than those in the control group (P < 0.05). PaO2 and oxygenation index of the two groups were higher than before treatment, and the observation group was higher than the control group, the difference was statistically significant (P < 0.05). The APACHE II score of the two groups was lower than that before treatment, and the observation group was lower than the control group, the difference was statistically significant (P < 0.05). The levels of TNF - α, IL-6 and CRP in the two groups were lower than those before treatment, and the observation group was lower than the control group (P < 0.05).The levels of CD3 +, CD4 +, CD8 + in the two groups were higher than those before treatment, and the observation group was higher than the control group, the difference was statistically significant (P < 0.05). The total effective rate of the observation group was significantly higher than that of the control group (P < 0.05). Conclusion Qingyi Xianxiong decoction can relieve abdominal distension, abdominal pain and other clinical symptoms of SAP patients, restore gastrointestinal function, reduce lung injury, reduce systemic inflammatory reaction, and restore the balance of body immune state.
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