The Clinical Study of Kansui Root Therapy for Severe Acute Pancereatitis
- Author:
- No author available
- Journal Title:
- JOURNAL OF CHINESE PHYSICIAN
- Issue:
- 11
- DOI:
- 10.3760/cma.j.issn.1008-1372.2004.11.002
- Key Word:
- 急性胰腺炎;甘遂;炎症介质;微循环;治疗
Abstract： 目的探讨中药甘遂在治疗重症急性胰腺炎(SAP)中的作用及其机制.方法将37例SAP患者随机分为甘遂组和对照组,观测和对比两组临床指数,实验室指标和Balthazar CT评分.结果(1)两组入院时的相关指标均无显著性差异(均P＞0.05).(2)血清TNFα、IL-6:治疗后3,7,14d甘遂组显著低于对照组(P＜0.05或P＜0.01).(3)血浆TXB2、6-keto-PGF1α及TXB2/6-keto-PGF1α比值:入院后3,7,14dTXB2较对照组显著降低(P＜0.05或P＜0.01),而6-keto-PGF1α各时点两组无显著差别(P＜0.05),TXB2/6-keto-PGF1α比值于入院后14d甘遂组显著低于对照组(P＜0.05或P＜0.01).(4)腹痛缓解时间、肠鸣音恢复时间、血、尿淀粉酶正常时间、体温和白细胞计数恢复时间:甘遂组均显著短于对照组(均P＜0.01).(5)APACHEⅡ评分和Balthzar CT分级评分:入院后7,14d于APACHEⅡ评分均显著低于对照组(P＜0.05或P＜0.01);Baltharzar CT分级评分于入院后14d甘遂组低于对照组(P＜0.05).(6)平均住院日、并发症发生率:甘遂组均显著低于对照组(P＜0.05或P＜0.01).(7)中转手术率、死亡率:两组比较无显著性差异(P＞0.05).结论(1)甘遂组治疗SAP有确切疗效.(2)甘遂可能通过下调TNFα、IL-6的血清水平达到治疗SAP的目的.(3)甘遂可能通过降低TXA2/PGI2比值从而改善胰腺微循环.(4)甘遂治疗SAP的作用机理可能是多途径、多靶点的.
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