大承气汤、大柴胡汤四联辨证治疗胃肠实热和肝胆湿热证早期急性胰腺炎及对血清炎症因子的影响

杨国红; 张翠; 王晓; 曾震军; 李春颖

doi:10.13422/j.cnki.syfjx.20180719

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大承气汤、大柴胡汤四联辨证治疗胃肠实热和肝胆湿热证早期急性胰腺炎及对血清炎症因子的影响

临床 | 更新时间：2024-01-04

- 大承气汤、大柴胡汤四联辨证治疗胃肠实热和肝胆湿热证早期急性胰腺炎及对血清炎症因子的影响
- Efficacy of Da Chengqitang, Da Chaihutang Quadruple Therapy of Syndrome Differentiation in Treatment of Early Acute Pancreatitis with Gastrointestinal Heat and Liver and Gallbladder Damp-heat Syndrome and Its Effect on Serum Inflammatory Factors
- 中国实验方剂学杂志 2018年24卷第8期页码：165-170
- 作者机构：
- 作者简介：
- 基金信息：
  
  河南省中医药科学研究专项（2014ZY02099）
- DOI：10.13422/j.cnki.syfjx.20180719
  中图分类号： R259
- 纸质出版日期：2018
- 稿件说明：
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杨国红, 张翠, 王晓, 等. 大承气汤、大柴胡汤四联辨证治疗胃肠实热和肝胆湿热证早期急性胰腺炎及对血清炎症因子的影响[J]. 中国实验方剂学杂志, 2018,24(8):165-170.

YANG Guo-hong, ZHANG Cui, WANG Xiao, et al. Efficacy of Da Chengqitang, Da Chaihutang Quadruple Therapy of Syndrome Differentiation in Treatment of Early Acute Pancreatitis with Gastrointestinal Heat and Liver and Gallbladder Damp-heat Syndrome and Its Effect on Serum Inflammatory Factors[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(8): 165-170.
杨国红, 张翠, 王晓, 等. 大承气汤、大柴胡汤四联辨证治疗胃肠实热和肝胆湿热证早期急性胰腺炎及对血清炎症因子的影响[J]. 中国实验方剂学杂志, 2018,24(8):165-170. DOI： 10.13422/j.cnki.syfjx.20180719.

YANG Guo-hong, ZHANG Cui, WANG Xiao, et al. Efficacy of Da Chengqitang, Da Chaihutang Quadruple Therapy of Syndrome Differentiation in Treatment of Early Acute Pancreatitis with Gastrointestinal Heat and Liver and Gallbladder Damp-heat Syndrome and Its Effect on Serum Inflammatory Factors[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(8): 165-170. DOI： 10.13422/j.cnki.syfjx.20180719.

摘要

目的：观察大承气汤、大柴胡汤四联辨证疗法治疗胃肠实热和肝胆湿热证早期急性胰腺炎（AP）的临床疗效及对血清炎症因子的影响。方法：将126例早期AP患者随机分为治疗组与对照组，各63例，对照组予常规西医治疗，治疗组在对照组治疗方案基础上，予中医辨证四联治疗（中药灌胃，胃肠实热证采用大承气汤加减，肝胆湿热证采用大柴胡汤加减；中药灌肠，采用大承气汤加减；中药外敷，采用清热散结方；静脉滴注活血化瘀药，灯盏花素注射液），疗程均为2周。分别观察两组患者腹痛、腹胀消失时间，肠鸣音以及血清淀粉酶（AMS），脂肪酶（LPS），白细胞（WBC），C反应蛋白（CRP）复常的时间；治疗前后修正CT严重指数（MCTSI）评分变化；两组治疗前后血清肿瘤坏死因子-α（TNF-α），白细胞介素-6（IL-6），白细胞介素-10（IL-10）含量的变化。结果：治疗后治疗组腹痛、腹胀消失时间，肠鸣音及血清AMS，LPS，WBC，CRP复常时间，MCTSI评分均优于对照组（P < 0.05）；两组患者治疗后血清TNF-α，IL-6水平均较治疗前降低，IL-10水平均较治疗前升高，且治疗组治疗后3，7 d血清TNF-α，IL-6的水平低于对照组，IL-10水平高于对照组（P < 0.05）；治疗后14 d两组血清TNF-α，IL-6，IL-10水平无统计学差异。结论：中医辨证四联疗法能明显改善AP患者临床症状、体征，实验室指标，MCTSI评分，能够早期下调血清TNF-α，IL-6水平，上调血清IL-10水平。

Abstract

Objective: To observe the clinical efficacy of Da Chengqitang

Da Chaihutang quadruple therapy of syndrome differentiation for treatment of early acute pancreatitis with gastrointestinal heat and liver and gallbladder damp-heat syndrome (AP) and its effect on the serum inflammatory factors. Method: A total of 126 cases of early AP patients were randomly divided into treatment group and control group

with 63 cases in each group. The control group was treated with conventional western medicine therapy

while the treatment group was treated with quadruple therapy of traditional Chinese medicine (TCM) syndrome differentiation in addition to the therapy of the control group (Intragastric administration of TCM decoction:Da Chengqitang for gastrointestinal heat syndrome

Da Chaihutang for syndrome of dampness-heat of liver and gallbladder; TCM enema; Da Chengqitang for TCM enema; Qingre Sanjie decoction for external application of TCM; intravenous dripping with blood circulation drug

injection with breviscapine). The course of treatment was 2 weeks. The two groups were observed for the disappearance time of abdominal pain and abdominal distension

and the recovery time of bowel sound and serum amylase (AMS)

lipase (LPS)

white blood cell (WBC) and C reactive protein (CRP). The changes in the modified computed tomography severity index (MCTSI) were scored before and after treatment. The content changes in serum tumor necrosis factor-α (TNF-α)

interleukin (IL)-6

IL-10 before and after treatment of the two groups were observed. Result: The disappearance time of abdominal pain and abdominal distension

and the recovery time of bowel sounds and serum AMS

LPS

WBC

CRP and the MCTSI score after treatment in the treatment group were better than those in the control group (P<0.05). For the patients of the two groups

the levels of serum TNF-α

IL-6 after treatment were lower than those before treatment

the level of IL-10 was higher than that before treatment

the concentration levels of serum TNF-α

IL-6 in treatment group on the third and seventh days were lower than those in control group

the level of IL-10 was higher than that of the control group (P<0.05); The concentrations of serum TNF-α

IL-6

IL-10 were basically the same on the fourteenth day in the two groups. Conclusion: Quadruple therapy of TCM syndrome differentiation can obviously improve the clinical symptoms

signs

laboratory indexes

MCTSI scores

and can reduce the concentrations of serum TNF-α and IL-6

and raise the concentration of serum IL-10.

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