摘要
目的:探讨柴芍承气汤加味银杏叶对重症急性胰腺炎(SAP)肺损伤的防治作用及其机制.方法:SAP患者65例分为中药组(n=35)和对照组(n=30).分别观察2组患者低氧血症发生情况,腹痛缓解时间、肠鸣恢复时间、局部并发症及病死率,治疗72h后血中炎症介质血小板活化因子(PAF)、肿瘤坏死因子(TNF-α)、白介素-1(IL-1)的水平变化,并再次行上腹部螺旋CT扫描评估胰腺炎症进展情况.结果:中药组与对照组低氧血症的发生率分别为45.71%,73.33%(P<0.05);ARDS分别为8.57%,30%(P<0.05);治疗72h后中药组血中PAF(4.45±1.25vs2.83±1.64mg/L,P<0.01),TNF-α(32.96±4.33vs27.82±5.26ng/L,P<0.01),IL-1(3.46±1.07vs2.51±0.52ng/L,P<0.01)水平明显下降,而对照组血中PAF,TNF-α,IL-1水平无变化;中药组腹痛缓解时间、肠鸣恢复时间、CT扫描显示胰腺炎程度进展的比例明显低于对照组(P<0.05);2组局部并发症的发生率分别为2.86%,13.33%,病死率分别为0,10%.结论:柴芍承气汤加味银杏叶对SAP肺损伤有防治作用,抑制PAF,TNF-α,IL-1等炎症介质可能是该汤剂防治肺损伤的重要机制.
AIM： To explore the preventive and therapeutic effects of Chaishao Chengqi decoction （CCD） with ginkgo biloba leaf （GBL） on the lung injury induced by severe acute pancreatitis （SAP）.
METHODS： A total of 65 SAP patients were divided into group A （n = 35） and B （n = 30）. Besides internal treatment, the patients in group A also received CCD plus GBL. The occurrence of hypoxemia, duration of abdominal pain-relief, recovering time of borborygmus, local complications, and mortality rate as well as the level changes of serum platelet-activating factor （PAF）, tumor necrosis factor-α （TNF-α）, and interleu- kin-1 （IL-1） 72 h after treatment were observed, respectively. Upper abdominal spiral CT scanning was used to evaluate the degrees of severe acute pancreatitis.
RESULTS： The incidence rates of hypoxemia and acute respiratory distress syndrome were significantly lower group A than those in group B （45.71% vs 73.33%, P 〈 0.05; 8.57% vs 30%, P 〈 0.05）. The serum levels of inflammatory factors dropped markedly in group A 72 h after treat- ment （PAF： 4.45 ± 1.25 → 2.83 ± 1.64 mg/L, P 〈 0.01; TNF-α： 32.96 ± 4.33 → 27.82 ± 5.26 ng/L, P 〈 0.01; IL-I： 3.46 ± 1.07→ 2.51 ± 0.52 ng/L, P 〈 0.01）, but they had no changes in group B. The duration of abdominal pain-relief, recovering time of borborygmus and progressive propor- tion of pancreatic inflammation were decreased in group A as compared with those in group B （P 〈 0.05）. The rates mortality and local complications were 0 and 2.86% in group A, and 10% and 13.33% in group B, respectively.
CONCLUSION： CCD plus GBL has preventive and therapeutic action on the SAP-induced lung injury, and the mechanism is probably related to its inhibition on the secretion of inflammatory mediators.
出处
《世界华人消化杂志》
CAS
北大核心
2006年第26期2636-2639,共4页
World Chinese Journal of Digestology
基金
南京市医学科技发展重点项目
No.ZKX0325~~
关键词
胰腺炎
肺损伤
柴芍承气汤
银杏叶
炎症
介质
Severe acute panreatitis
Lung injury
Chaishao Chengqi Decoction
Ginkgo biloba leaf
Inflammatory mediators
