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[目的]探讨中药清胰汤对重症急性胰腺炎(SAP)患者的治疗作用及对细胞因子白细胞介素8、10(IL-8、IL-10)的影响。[方法]将符合SAP诊断标准的患者随机分为综合治疗组和联合清胰汤组,综合治疗组给予常规西药、胃肠减压等治疗,联合清胰汤组给予清胰汤加综合治疗,其他辅助治疗及护理等影响因素相同,分别检测发病24 h内,第2、4天的IL-8I、L-10水平及入院后第4、8天患者的APACHE-Ⅱ评分、血清淀粉酶(AMY)、血清清蛋白(Alb)及三酰甘油(TG)水平。并选取轻症急性胰腺炎(MAP)作为对照。[结果]发病24 h内SAP患者的IL-8、IL-10水平均明显高于MAP患者(P<0.05);联合清胰汤组第2、4天IL-8I、L-10水平低于综合治疗组(P<0.05)。SAP 2组患者治疗前后AMY、Alb水平无显著变化,但联合清胰汤组血清TG水平及APACHE-Ⅱ评分明显低于综合治疗组(P<0.05)。[结论]SAP患者全身炎症反应综合征(SIRS)的程度明显重于MAP患者;清胰汤联合西药治疗能有效降低APACHE-Ⅱ评分,清胰汤治疗SAP的可能机制是通过减少急性期IL-8I、L-10等细胞因子的释放而抑制SIRS反应。
[Objective] To investigate the therapeutic effect of Chinese herbal medicine Qingyi Decoction on patients with severe acute pancreatitis (SAP) and the effects of interleukin-8, 10 (IL-8, IL-10) on cytokines. [Methods] Patients meeting SAP diagnostic criteria were randomly divided into comprehensive treatment group and combined Qingyi Decoction group. Comprehensive treatment group was given conventional western medicine, gastrointestinal decompression, etc., combined Qingyi Decoction group was given Qingyi Decoction and comprehensive treatment, and others. The influence factors of adjuvant therapy and nursing were the same. The levels of IL-8 and L-10 on the 2nd and 4th days and the APACHE-II score on the 4th and 8th days after admission were measured within 24 h after onset. Serum amylase (AMY) ), serum albumin (Alb) and triglyceride (TG) levels. And mild acute pancreatitis (MAP) was chosen as a control. [Results] The levels of IL-8 and IL-10 in patients with SAP within 24 hours after onset were significantly higher than those in patients with MAP (P<0.05); the levels of IL-8 and IL-10 on the 2nd and 4th days in the combined Qingpan Decoction group were lower Comprehensive treatment group (P <0.05). There was no significant change in AMY and Alb levels before and after treatment in SAP group 2, but serum TG levels and APACHE-II scores in the combined Qingyi Decoction group were significantly lower than those in the comprehensive treatment group (P<0.05). [Conclusion] The degree of systemic inflammatory response syndrome (SIRS) in SAP patients is significantly heavier than that of MAP patients; Qingyitang combined with western medicine treatment can effectively reduce the APACHE-II score. Qingyitang’s possible mechanism for the treatment of SAP is to reduce acute phase IL- The release of cytokines such as 8I and L-10 suppresses the SIRS response.