摘要
[目的]观察中西医结合防治重症急性胰腺炎(SAP)肾损害的临床疗效。[方法]将86例SAP患者随机分为对照组和治疗组,各43例。均给予常规西医治疗,治疗组在此基础上用生大黄、芒硝和川芎嗪联合治疗,观察两组肾损害的主要临床指标、血浆肿瘤坏死因子α(TNFα)、白细胞介素6(IL6)、内毒素(LPS)和血管紧张素Ⅱ(ATⅡ)水平及全身炎症反应综合征(SIRS)、急性肾功能衰竭(ARF)、多功能器官综合征(MODS)发生率、病死率和平均住院天数的变化。[结果]治疗组肾损害的主要临床指标的发生率明显降低(P<0.05),血浆TNFα、IL6、LPS和ATⅡ水平明显降低(P<0.05),SIRS、ARF、MODS发生率明显减少(P<0.05),缩短了住院日(P<0.01),病死率有所下降,但差异无统计学意义。[结论]生大黄、芒硝和川芎嗪通过抑制和拮抗LPS和细胞因子,降低了ATⅡ水平,改善胰、肾微循环障碍,减轻了胰腺炎症的发展和肾损害,改善了肾功能;有效地防治SAP肾损害的发生,提高SAP的治愈率。
Objective] To observe the clinical curative effect of integrative therapy of Chinese and western medicine on 43 cases of serious acute pancreatitis (SAP) patients with kidney injury. [Methods] Eighty-six cases with SAP were divided randomly into treatment group (n=43) and control group (n=43). Both group were given routine western medicine, besides, the treatment group was given Rhubarb, Mirabilite and ligustrazire. Main clinical signs of kidney injury were observed. Plasma levels of TNF-a, IL-6, LPS and ATⅡwere examined. Incidence of SIRS, ARF, MODS, mortality and mean days in ward were also investigated. [Results] The incidence of main clinical signs of kidney injury in the treatment group was significantly lower than that in the control group. The plasma levels of TNF-a, IL-6, LPS and ATⅡ in the treatment group decreased obviously. The incidence of SIRS, ARF, MODS in the treatment group was also significantly lower than that in the control group. Mean days in ward were decreased markedly. Although the overall mortality in the treatment group was also lower than that in the control group, there was no statistical difference between the two groups. [Conclusion] Rhubarb, Mirabilite and ligustrazire could relieve immune inflammatory response by inhibiting cytokines and LPS, lower the plasma levels of ATⅡ, simultaneously relieve pancreatitis and kidney injury, and improve the renal function by improving the microcirculation of pancreas and kidney, so as to reduce the incidence of kidney injury effectively, increase the curative rate and improve the prognosis of SAP.
出处
《中国中西医结合消化杂志》
CAS
2005年第3期184-186,共3页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
关键词
胰腺炎
重症急性
肾损害
中西医结合疗法
severe acute parcveatitis (SAP)
kidney injury
integrative therapy of Chinese and western medicine
