[1]杨佳平,赵江桥,薛敏芝,等.加味大承气汤灌肠辅助分级护理对急性胰腺炎患者疗效及血清IL-6、TNF-α的影响[J].西部中医药,2024,37(03):115-120.[doi:10.12174/j.issn.2096-9600.2024.03.23]
　YANG Jiaping,ZHAO Jiangqiao,XUE Minzhi,et al.Therapeutic Effects of Modified Dachengqi Tang Enema-assisted Hierarchical Nursing in the Treatment of Acute Pancreatitis and Its Influence on Serum IL-6 and TNF-α Levels[J].Western Journal of Traditional Chinese Medicine,2024,37(03):115-120.[doi:10.12174/j.issn.2096-9600.2024.03.23]
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加味大承气汤灌肠辅助分级护理对急性胰腺炎患者疗效及血清IL-6、TNF-α的影响
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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
37
期数:
2024年03期
页码:
115-120
栏目:
临床研究
出版日期:
2024-03-15

文章信息/Info

Title:
Therapeutic Effects of Modified Dachengqi Tang Enema-assisted Hierarchical Nursing in the Treatment of Acute Pancreatitis and Its Influence on Serum IL-6 and TNF-α Levels
作者:
杨佳平, 赵江桥, 薛敏芝, 张培军, 杜国涛, 兰涛
沧州市人民医院，河北 沧州 061000
Author(s):
YANG Jiaping, ZHAO Jiangqiao, XUE Minzhi, ZHANG Peijun, DU Guotao, LAN Tao
Cangzhou People's Hospital, Cangzhou 061000, China
关键词:
急性胰腺炎; IL-6; TNF-; 淀粉酶; 二胺氧化酶; 加味大承气汤; 灌肠; 分级护理
Keywords:
acute pancreatitis; IL-6; TNF-; amylase; diamine oxidase; modified; enema; hierarchical nursing
分类号:
R243
DOI:
10.12174/j.issn.2096-9600.2024.03.23
文献标志码:
B
摘要:
目的探讨加味大承气汤灌肠辅助分级式护理对急性胰腺炎（acute pancreatitis，AP）腑实热结型患者疗效及血清白细胞介素6（interleukin-6，IL-6）、肿瘤坏死因子α（tumor necrosis factor α，TNF-α）水平的影响。 方法将84例腑实热结型AP患者按照随机数字表法分为对照组和观察组各42例，两组患者均行常规支持治疗，对照组予分级式护理干预，观察组在对照组基础上应用加味大承气汤灌肠，干预1周后观察两组患者血清IL-6、TNF-α、水通道蛋白5（aquaporin 5，AQP5）、水通道蛋白6（AQP6）、淀粉酶（amylase，AMY）、二胺氧化酶（diamine oxidase，DAO）、D-乳酸（D-lactic acid，D-LA）水平及临床症状缓解时间、急性胰腺炎严重程度估计指标（Ranson评分）、胰腺CT严重程度评估（CTSI评分）、急性生理学与慢性健康状况评分Ⅱ（acute physiology and chronic health evaluationⅡ，APACHEⅡ）、中医症状评分等变化情况，并评估两组患者临床疗效。 结果治疗后，两组患者血清IL-6、TNF-α水平较治疗前下降，AQP5、AQP6水平较治疗前上升，观察组各指标改善均优于对照组（P＜0.05）；治疗后，两组患者血清AMY、DAO和D-LA水平较治疗前下降，观察组低于对照组（P＜0.05）；治疗后，观察组腹痛缓解、腹胀缓解、肛门排气、肠鸣音恢复、肛门排便时间均短于对照组（P＜0.05）；治疗后，两组患者Ranson、CTSI、APACHEⅡ评分较治疗前下降，观察组低于对照组（P＜0.05）；治疗后，两组患者腹痛、腹胀、恶心呕吐、发热、口干渴、尿赤短和大便秘结等评分较治疗前下降，观察组低于对照组（P＜0.05）；观察组总有效率为95.24%（40/42），高于对照组的78.57%（33/42）（P＜0.05）。 结论加味大承气汤灌肠辅助分级护理可通过减轻肠黏膜损伤，促进胃肠功能恢复，抑制血清IL-6、TNF-α表达水平，增加AQP5、AQP6表达，来改善腑实热结型AP患者临床症状。
Abstract:
ObjectiveTo explore the curative effects of modified Dachengqi Tang enema-assisted hierarchical nursing in the treatment of acute pancreatitis (AP) of Fu-organs excess and heat accumulation pattern and its influence on the levels of IL-6 and TNF-α. MethodsAll 84 AP patients were separated into the control group and the observation group with 42 cases in each group according to random number table method, both groups accepted conventional supportive treatment, the control group was given graded nursing intervention, and the observation group accepted modified Dachengqi Tang enema on the foundation of the therapy the control group received, after one week of the intervention, to observe the levels of serum IL-6, TNF-α, AQP5, AQP6, AMY, DAO and D-LA, clinical symptoms remission time, Ranson scores, CTSI, APACHEⅡ and TCM symptoms scores between both groups, and to assess clinical effects between the two groups. ResultsAfter the treatment, the levels of serum IL-6 and TNF-α were lowered in the two groups than before the treatment, the levels of AQP5 and AQP6 were increased than before the treatment, the improvements of these indexes of the observation group were better than those of the control group (P<0.05); after the treatment, the levels of serum AMY, DAO and D-LA were reduced in the two groups than before the treatment, the observation group was lower than the control group (P<0.05); after the treatment, the observation group was less than the control group in abdominal pain relief time, abdominal distension relief time, anal exhaust time, the recovery time of bowel sound and anal defecation time (P<0.05); after the treatment, Ranson scores, CTSI and APACHEⅡ scores of the groups were decreased than before the treatment, the observation group was lower than the control group (P<0.05); after the treatment, the scores of abdominal pain, abdominal distension, nausea and vomiting, fever, dry mouth and thirsty, painful urination and constipation were reduced in the two groups than those before the treatment, the observation group was lower than the control group (P<0.05); total effective rate of the observation group was 95.24% (40/42), higher than 78.57%(33/42) of the control group (P<0.05). Conclusionmodified Dachengqi Tang enema-assisted hierarchical nursing could improve clinical symptoms of AP patients of Fu-organs excess and heat accumulation pattern by reducing intestinal mucosal damage, promoting gastrointestinal function recovery, lowering the levels of serum IL-6 and TNF-α, enhancing the expressions of AQP5 and AQP6.

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备注/Memo

备注/Memo:
杨佳平（1984—），女，主管护师。研究方向：肝胆胰疾病的中西医结合护理。E-mail：yangjiaping120@163.com。沧州市科学技术研究与发展指导计划（162302051）。
更新日期/Last Update: 2024-03-15