大黄牡丹汤对重症急性胰腺炎患者内毒素、TNF-α及不良反应的影响

文章信息/Info

• Title:Study on the effect of Dahuangmudan Decoction on endotoxin, TNF-α and adverse reactions in patients with severe acute pancreatitis

• 卷期:2021年19卷24期

• 作者:朱彦哲

• 中国医科大学附属盛京医院急诊科 辽宁沈阳 110001

• Author(s):Zhu Yanzhe

• Department of Emergency, Shengjing Hospital, China Medical University, Shenyang 110001, Liaoning Province

• 关键词:大黄牡丹汤；重症急性胰腺炎；内毒素；TNF-α；不良反应

• Keywords: Dahuang Mudan Decoction; severe acute pancreatitis; endotoxin; TNF-α; adverse reactions

• 摘要:目的：探讨大黄牡丹汤对重症急性胰腺炎患者内毒素、TNF-α及不良反应的影响。方法：收集我院急性重症监护室（EICU）收治的重症急性胰腺炎患者66例，随机分为试验组和对照组，各33例。对照组予以丙氨酰谷氨酰胺注射液100ml静脉滴注，每日2次；试验组在对照组的基础上予以大黄牡丹汤治疗。比较患者临床疗效、脂质过氧化物(LPO)、超氧化物岐化酶(SOD)、过氧化氢酶(CAT)、肿瘤坏死因子-α（TNF-α）、内毒素以及并发症发生情况。结果：与对照组相比69.79%，试验组治疗有效率90.91%较高（P＜0.05），试验组LPO、TNF-α、内毒素水平较低，SOD、CAT水平较高（P＜0.05），试验组并发症发生率较低（P＜0.05）。结论：大黄牡丹汤治疗重症急性胰腺炎患者能抑制TNF-α的表达、减少肠道内毒素易位，清除机体自由基，有效改善患者临床症状，抑制机体的炎症反应。                                                                                                                                

• Abstract:Objective:To investigate the effect of Dahuangmudan Decoction on endotoxin, TNF-α and adverse reactions in patients with severe acute pancreatitis. Methods: 66 patients with severe acute pancreatitis in the acute intensive care unit (EICU) of our hospital were randomly divided into Study group and control group, 33 cases each. The control group received alanyl glutamine injection 100ml iv, tid, the Study group received more with Dahuangmudan Decoction. The clinical efficacy, lipid peroxide (LPO), superoxide dismutase (SOD), catalase (CAT), tumor necrosis factor-α (TNF-α), endotoxin and complications were compared. Results: Compared with the control group69.79%, the effective rate of the study group90.91% was higher(P<0.05), levels of LPO, TNF - α and endotoxin were lower, SOD and cat were higher(P<0.05), and incidence of complications in the Study group was lower (P<0.05). Conclusion: Dahuang Mudan decoction can inhibit the expression of TNF-α, reduce the translocation of intestinal endotoxin, clear free radicals, effectively improve the clinical symptoms of patients with severe acute pancreatitis and inhibit the inflammatory reaction of the body.                                                                                                                                                                                                                

  重症急性胰腺炎（SAP）是一种临床常见的消化系统疾，本病的病情险恶、并发症多、病死率高，患者多合并多器官功能障碍，严重者可诱发感染、腹膜炎、休克、全身炎症反应综合征以及多器官功能障碍综合征等严重疾患，本病的发病与胆道感染、暴饮暴食以及酗酒等原因有关。西药治疗本病虽然对近期的治疗效果显著，对体内自由基的清除以及调控炎症因子有一定的作用效果，但远期疗效较差，不良反应较多。中医药治疗本病取得了一定疗效，尤其在对机体炎症反应以及氧化自由基的控制作用较为显著，近期我科将大黄牡丹汤应用于重症急性胰腺炎的治疗，疗效肯定。