摘要
目的观察大承气汤加减联合腹腔镜下置管灌洗引流术对重症急性胰腺炎患者血清二胺氧化酶(DAO)、T淋巴细胞亚群水平变化的影响。方法将78例重症急性胰腺炎患者随机分为2组。对照组39例行腹腔镜下置管灌洗引流术治疗;治疗组39例在对照组治疗基础上加大承气汤加减治疗。2组均治疗7 d后观察统计疗效、并发症发生情况及主要症状(腹痛、压痛、腹胀)缓解或消失时间,检测对比2组治疗前后血清DAO及T淋巴细胞亚群CD4^+、CD8^+、CD4^+/CD8^+变化。结果治疗组临床疗效优于对照组(P<0.05),总有效率(92.31%)高于对照组(71.79%,P<0.05)。治疗后2组血清DAO水平及T淋巴细胞CD8^+均较本组治疗前降低(P<0.05),CD4^+、CD4^+/CD8^+升高(P<0.05),且2组组间比较差异有统计学意义(P<0.05)。治疗组腹痛、腹胀缓解时间及压痛消失时间均较对照组早(P<0.05),并发症总发生率低(P<0.05)。结论大承气汤加减联合腹腔镜下置管灌洗引流术能有效调节重症急性胰腺炎患者血清DAO及T淋巴细胞亚群水平,效果显著。
Objective To investigate the effect of modified Dachengqi decoction combined with laparoscopic lavage and drainage on the changes of serum levels of diamineoxidase(DAO)and T cell subsets in patients with severe acute pancreatitis.Methods 78 cases of severe acute pancreatitis were randomly divided into two groups,39 cases in control group were treated by laparoscopic lavage and drainage,and 39 cases in treatment group were treated by modified Dachengqi decoction on the basis of control group treatment.After 7 days of treatment,the therapeutic effect,complications,remission time of main symptoms(abdominal pain,pressure pain,abdominal distention)of the two groups were observed and statistically recorded.The serum levels of DAO and T cells subsets(CD4+,CD8+,CD4+/CD8+)before and after the treatment were measured and compared between the two groups.Results The therapeutic effect of the treatment group was better than that of the control group(P<0.05),and the total effective rate(92.31%)was higher than that of the control group(71.79%,P<0.05).After treatment,the serum DAO levels and CD8+T lymphocytes in both groups were lower than those before treatment(P<0.05),and CD4+and CD4+/CD8+levels were elevated(P<0.05),and the difference between the two groups was statistically significant(P<0.05).The abdominal pain,bloating relief time and tenderness disappearance time in the treatment group were shorter than those in the control group(P<0.05),and the total incidence of complications was low(P<0.05).Conclusion Modified Dachengqi decoction combined with laparoscopic lavage and drainage can effectively regulate the level of serum DAO and T lymphocyte subsets,and the effect is significant.
作者
夏正新
方玉明
肖勇
XIA Zhengxin;FANG Yuming;XIAO Yong(Department of Emergency,The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine,ShangHai 201999)
出处
《河北中医》
2018年第4期550-554,共5页
Hebei Journal of Traditional Chinese Medicine
关键词
胰腺炎
急性坏死性
大承气汤
腹腔灌洗
中西医结合疗法
胺氧化酶(含铜)
T淋巴细胞
Pancreatitis,acute necrosis
Dachengqi Decoction
Peritoneal lavage
Integrated Traditional Chinese and Western Medicine
Amine oxidase(including copper)
T lymphocytes
