针药结合治疗急性胰腺炎的临床效果研究

doi:10.3969/j.issn.1004-7115.2021.04.022

摘要/Abstract

摘要： 目的观察中西医结合疗法治疗急性胰腺炎(AP)的临床效果。方法选取2018年2月至2020年10月收治的70例急性胰腺炎(acute pancreatitis,AP)患者,采用随机数字表法将患者分为观察组和对照组,每组各35例,两组的年龄、性别、病情严重程度等临床资料差异无统计学意义。对照组接受常规西医治疗,观察组在治疗组的基础上加用针刺疗法联合茵陈蒿汤治疗。对比两组治疗后临床疗效及相关指标的变化,包括腹痛和腹胀的消失时间、血清淀粉酶和尿淀粉酶恢复时间,同时观察治疗前后炎症反应指标的差异,包括血清C反应蛋白 (CRP)、降钙素原(PCT)、肿瘤坏死因子α(TNF-α)的表达水平。结果观察组治疗总有效率明显高于对照组 (P<0.01),观察组患者腹痛、腹胀消失时间以及淀粉酶恢复时间较对照组明显缩短,治疗后观察组血清CRP、PCT、TNF-α表达水平均明显低于对照组,差异有统计学意义(P<0.01)。结论针刺疗法联合茵陈蒿汤辅助治疗AP疗效显著,可以快速缓解临床症状,减轻炎症因子的释放,值得临床进一步研究。

关键词: 急性胰腺炎, 针刺疗法, 中药, 炎症因子, 疗效

Abstract: Objective: To observe the clinical effect of combined Traditional Chinese and western medicine in the treatment of acute pancreatitis (AP).Methods: A total of 70 AP patients admitted from February 2018 to October 2020 were selected and divided into observation group(n=35) and control group(n=35) by random number table method. There was no statistical difference in age, sex, degree of disease and other general information between the two groups.The control group received conventional western medicine treatment, and the observation group was treated with acupuncture therapy combined with Yinchenhao decoction on the basis of the treatment group. Clinical curative effect and the related indicators of change, including the disappearance of the abdominal pain and abdominal distention time, serum amylase and urine amylase recovery time were compared after treatment of the two groups, and the differences of inflammation indexes before and after treatment were observed, including serum c-reactive protein (CRP),procalcitonin(PCT), tumor necrosis factor alpha (TNF-α) expression level.Results: The total effective rate of treatment in the observation group was significantly higher than that in the control group (P<0.01); the time for abdominal pain, abdominal distension and amylase recovery in the observation group were significantly shorter than that in the control group; the expression levels of serum CRP, PCT and TNF-αthe observation group were significantly lower than those in the control group after treatment, and the differences were statistically significant (P<0.01).Conclusion: Acupuncture therapy combined with Yinchenhao decoction has a definite therapeutic effect on AP, which can quickly relieve clinical and symptoms and reduce the release of inflammatory factors, which can guide further clinical research.

Key words: acute pancreatitis, acupuncture therapy, Traditional Chinese medicine (TCM), inflammatory factors, curative effect

中图分类号:

R576

戴文玲. 针药结合治疗急性胰腺炎的临床效果研究[J]. betway必威登陆网址（betway.com ）学报, 2021, 42(4): 308-311.

DAI Wen-ling. Clinical effect of acupuncture combined with medicine in the treatment of acute pancreatitis[J]. Journal of Shandong First Medical Unversity & Shandong Academy of Medical Sciences, 2021, 42(4): 308-311.

参考文献

[1] 李淑娜,李义.急性胰腺炎近十年针刺治疗研究进展[J].海南医学,2020,31(2):236-239.
[2] 索明果,李英宽.乌司他丁联合生长抑素治疗重症急性胰腺炎的临床效果[J].河南医学研究, 2020,29(16):2940-2941.
[3] 王丽,王玉玲.中西医结合非手术治疗重症急性胰腺炎患者的护理研究进展[J].医疗装备, 2020,33(8):192-193.
[4] 张声生,李乾构,李慧臻,等.急性胰腺炎中医诊疗专家共识意见[J].中华中医药杂志,2013, 28(6):1826-1831.
[5] 中华医学会外科学分会胰腺外科学组.急性胰腺炎诊治指南(2014)[J].临床外科杂志, 2015,23(1):1-3.
[6] 冯燕,叶梅惠,虞弘,等.中药联合莫沙必利治疗中重症急性膜腺炎并发肠麻痹的疗效观察[J].临床消化病杂志,2019,31(1):40-43.
[7] 李高辉,吕文良.简述茵陈蒿汤的古今临床研究[J].辽宁中医药大学学报,2020,22(07):90- 95.
[8] 汪镜静,李倩.急性胰腺炎与分子水平标志物研究进展[J].沈阳医学院学报,2018,20(6):541- 544.
[9] 曹洁,姚隆.重症急性胰腺炎营养治疗的研究进展.重庆医学,2020,49(15):2583- 2587.
[10] 葛均波,徐永健,王辰.内科学[M].9版.北京:人民卫生出版社,2018:429-430.
[11] 郭笑宇,肖繁,王刚,等.急性胆源性胰腺炎内镜治疗的研究进展[J].中国普外基础与临床杂志:1-5.
[12] 郑西,何文华,吕农华.2018年国际急性胰腺炎研究进展[J].中华胰腺病杂志,2019,19(4):241- 244.
[13] Rijkers AP,Vaneijck CH.Acute pancreatitis[J].N Engl J Med,2017,376(6):596-597.
[14] 何清,王立为.营养支持、生长抑素联合乌司他丁治疗重症急性胰腺炎疗效分析[J].临床军医杂志,2018,46(3):248-250.
[15] 安东,徐磊.急性胰腺炎患者外周血NGAL和胃饥饿素水平变化及其意义[J].中国普通外科杂志,2016,25(9):1331-1335.
[16] 郭丽霞,王彩芹,陶丽娟,等.通里攻下中药联合早期肠内营养治疗急性重症胰腺炎临床研究[J].中国药业,2019,28(1):63-65.
[17] 彭春燕,韩真.C反应蛋白、血钙和胸腔积液对急性胰腺炎早期预后的评估[J].皖南医学院学报,2013,32(3):213-215.
[18] 陈国铭,汤顺莉,邝梓君,等.基于系统药理学的茵陈作用机制研究[J]中国药房,2018,29 (10):1312-1319.
[19] 史永平,孔浩天,李昊楠,等.栀子的化学成分、药理作用研究进展及质量标志物预测分析[J].中草药,2019,50(2):281-289.
[20] 尹姣定.栀子苷的研究进展[J].健康周刊,2017,(36):8-13.
[21] 刘静,王丽.大黄素的研究进展[J].中国药房,2014,25(35):3351-3354.
[22] 冯燕,叶梅惠,虞弘,等.中药联合莫沙必利治疗中重症急性膜腺炎并发肠麻痹的疗效观察[J].临床消化病杂志2019,31(1):40-43.
[23] 郑琪,吴杰.针刺足三里治疗急性胰腺炎临床观察[J].光明中医,2019,34(2):214-216.
[24] 尹望华,蒋雪萍,李正定,等.电针治疗仪输出脉冲电压测量不确定度分析与评定[J].计量与测试技术,2019,46(3):96-97.