林麗君++周春姣++何軍明+劉明++蔡炳勤

[摘要] 目的 探討吳茱萸+芒硝外用輔助干預(yù)對(duì)重癥胰腺炎患者全身炎性反應(yīng)程度、靶器官損傷程度的影響。 方法 收集2013年2月～2017年1月廣東省中醫(yī)院收治的重癥胰腺炎患者80例，按照單盲隨機(jī)對(duì)照法將入組患者分為兩組，每組各40例。對(duì)照組接受常規(guī)治療，觀察組在此基礎(chǔ)上加入?yún)擒镙?芒硝外用輔助干預(yù)。入院即刻、治療1周后，采用酶聯(lián)免疫吸附法（ELISA）測(cè)定血清炎癥指標(biāo)含量，采用半自動(dòng)生化分析儀檢測(cè)血清肝功能指標(biāo)含量，采用分光光度計(jì)法檢測(cè)血清腸黏膜屏障指標(biāo)含量。 結(jié)果 入院即刻，兩組全身炎性反應(yīng)程度、肝功能及腸黏膜屏障功能比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P > 0.05）。治療1周后，兩組患者血清中白介素-6（IL-6）、白介素-8（IL-6）、單核細(xì)胞趨化蛋白-1（MCP-1）、谷丙轉(zhuǎn)氨酶（ALT）、總膽紅素（TBiL）、堿性磷酸酶（AKP）、D-乳酸、二胺氧化酶（DAO）、內(nèi)毒素的含量低于入院即刻，且觀察組血清中IL-6、IL-8、MCP-1、ALT、TBiL、AKP、D-乳酸、DAO、內(nèi)毒素的含量低于對(duì)照組（P < 0.05）。 結(jié)論 吳茱萸+芒硝外用輔助干預(yù)可緩解重癥胰腺炎患者的全身炎性反應(yīng)程度，保護(hù)靶器官功能。

[關(guān)鍵詞] 重癥胰腺炎；吳茱萸；芒硝；全身炎性反應(yīng)；靶器官損傷

[中圖分類號(hào)] R657.51 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1673-7210（2017）11（c）-0147-04

Study on the efficacy of external adjuvant application of Fructus Evodiae plus Natrii Sulfas on severe acute pancreatitis

LIN Lijun ZHOU Chunjiao HE Junming LIU Ming CAI Bingqin

Department of Hepatopancreatobiliary Surgery， Guangdong Hospital of Traditional Chinese Medicine， Guangdong Province， Guangzhou 510120， China

[Abstract] Objective To study the influence of external adjuvant application of Fructus Evodiae plus Natrii Sulfas on the degree of systemic inflammatory response and target organ damage in patients with severe acute pancreatitis. Methods Eighty cases of patients with severe acute pancreatitis admitted to Guangdong Hospital of Traditional Chinese Medicine from February 2013 to January 2017 were collected， and the enrolled patients were divided into two groups by single blind randomized controlled method， with 40 cases in each group. The control group received conventional therapy， on basis of which， the observation group was added with external adjuvant application of Fructus Evodiae plus Natrii Sulfas. At admission， one week after treatment， the contents of serum inflammatory indexes were measured by enzyme linked immunosorbent assay （ELISA）， the contents of serum liver function indexes were detected by semi automatic biochemical analyzer， the contents of intestinal mucosal barrier indexes were measured by spectrophotometer method. Results At admission， there were no significant differences in the degree of systemic inflammatory response， liver function and intestinal mucosal barrier function between the two groups （P > 0.05）. One week after treatment， the contents of serum interleukin-6 （IL-6）， interleukin-8 （IL-6）， monocyte chemoattractant protein-1 （MCP-1）， alanine aminotransferase （ALT）， total bilirubin （TBiL）， alkaline phosphatase （AKP）， lactic acid， D-amine oxidase （DAO）， endotoxin of the two groups were significantly lower than those at admission， and the contents of serum IL-6， IL-8， MCP-1， ALT， TBiL， AKP， D-lactic acid， DAO， endotox of observation group were significantly lower than those of control group （P < 0.05）. Conclusion External adjuvant application of Fructus Evodiae plus Natrii Sulfas can alleviate the degree of systemic inflammatory response in patients with severe acute pancreatitis， and protect target organ function.endprint