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目的:探讨生大黄灌肠辅助治疗对重症胰腺炎患者全身炎症应激反应及肠黏膜屏障功能的影响。方法:选取在本院接受治疗的78例重症胰腺炎患者,随机法将患者分为对照组、生大黄组各39例,对照组接受西医重症胰腺炎常规治疗、生大黄组在对照组基础上加入生大黄灌肠治疗,持续治疗1周后评估疗效。对比两组治疗前后血清中炎症介质[高迁移率族蛋白B1(HMGB1)、C反应蛋白(CRP)、前列腺素E2(PGE2)、肿瘤坏死因子α(TNF-α)]、应激激素[皮质醇(Cor)、肾上腺素(E)]、肠黏膜屏障功能指标[D-乳酸(D-Lactate)、内毒素(ET)、二胺氧化酶(DAO)]含量的差异。结果:治疗前,两组血清中炎症介质、应激激素、肠黏膜屏障功能指标含量的比较,差异无统计学意义(P>0.05)。治疗后,观察组血清中HMGB1、CRP、PGE2、TNF-α的含量低于对照组;Cor、E的含量低于对照组;D-Lactate、ET、DAO的含量低于对照组(P<0.05)。结论:重症胰腺炎患者在西医基础上使用生大黄灌肠辅助治疗,有助于缓解机体炎症应激反应并优化肠黏膜屏障功能。
Abstract：Objective: To investigate the effects of adjuvant raw rhubarb enema therapy on systemic inflammatory stress response and intestinal mucosal barrier function in patients with severe pancreatitis. Methods: 78 patients with severe pancreatitis were treated in our hospital between December 2016 and September 2018. The patients were divided into control group(n=39) and raw rhubarb group(n=39) by simple randomization. Control group received conventional treatment of severe pancreatitis with western medicine, raw rhubarb group received raw rhubarb enema on the basis of the treatment of control group, and the efficacy was evaluated after continuous treatment for 1 week. The differences in serum levels of inflammatory mediators[high mobility group protein B1(HMGB1), C-reactive protein(CRP), prostaglandin E2(PGE2) amd tumor necrosis factor α(TNF-α)], stress hormones[cortisol(Cor) and epinephrine(E)] as well as intestinal mucosal barrier function indicators[D-Lactate), endotoxin(ET) and diamine oxidase(DAO)] were compared between the two groups of patients before and after treatment. Results: Before treatment, there was no statistically significant difference in serum levels of inflammatory mediators, stress hormones and intestinal mucosal barrier function indicators between the two groups(P>0.05). After treatment, serum HMGB1, CRP, PGE2 and TNF-α levels of the observation group were lower than those of the control group; Cor and E levels were lower than those of the control group; D-lactate, ET and DAO levels were lower than those of the control group(P<0.05). Conclusion: Adjuvant raw rhubarb enema therapy on the basis of western medicine can help alleviate the inflammatory stress response and optimize the intestinal mucosal barrier function in patients with severe pancreatitis.
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基本信息:
DOI：10.13210/j.cnki.jhmu.20190322.002
中图分类号:R576
引用信息:
[1]方萍,肖先华.生大黄灌肠辅助治疗对重症胰腺炎患者全身炎症应激反应及肠黏膜屏障功能的影响[J].海南医学院学报,2019,25(09):687-690.DOI:10.13210/j.cnki.jhmu.20190322.002.
基金信息:
四川省中医药管理局科研项目(2060402)~~
2019-03-27
2019-03-27
2019-03-27