注射用灯盏花素联合ERCP治疗急性胆源性胰腺炎临床研究

发布时间：2018-05-25 03:33

本文选题：灯盏花素 + ERCP　；参考：《广州中医药大学》2015年硕士论文

【摘要】：目的：观察注射用灯盏花素联合ERCP治疗急性胆源性胰腺炎(ABP)的临床和实验指标,客观评价其对ABP患者的临床疗效,为中西医结合治疗ABP提供可靠的基础与临床依据,促进传统中医药学与西医先进技术结合治疗疾病的进程。方法：以入住广州军区总医院消化内科并确诊为急性胆源性胰腺炎的患者为研究对象,根据研究进行病例筛选,共77例。按照平行对照设计原理及随机原则,将患者分为治疗组(A组,灯盏花素联合ERCP)和对照组(B组,ERCP)。测定治疗前后血清TNF-α、IL-6、IL-8、IL-10、ET、CRP、TBIL、ALT、ALP、γ-GT. AMY的水平,观察两组患者腹痛缓解时间、平均住院时间、平均住院费用,比较两组患者并发胰腺脓肿、胰腺假性囊肿发生率及临床疗效,建立数据库,进行统计学分析。结果：1.两组治疗后血清TNF-α、IL-6、IL-8、IL-10均较治疗前显著下降(P0.05)。治疗后,两组的TNF-α、IL-6和IL-8分别比较,治疗组均较对照组下降得更显著(P0.05)。2.两组治疗后血清ET、CRP均较治疗前显著下降(P0.05)。治疗后,两组的ET和CRP分别比较,治疗组均较对照组下降得更显著(P0.05)。3.在治疗后3天及7天,两组的血清TBIL、ALP、γ-GT,均较治疗前显著下降(P0.05)。两组ALT在治疗后3天均较治疗前无显著下降(P0.05),在治疗后7天均较治疗前显著下降(P0.05)。血清TBIL、ALT、ALP、γ-GT在治疗后3天及7天,两组比较均无显著差异(P0.05)。4.在治疗后12h、24h、3d,两组血清淀粉酶均较治疗前显著下降(P0.05)。治疗后12h及3d,两组比较无显著差异(P0.05)。治疗后24h,治疗组比对照组下降得更显著(P0.05)。5.两组腹痛缓解时间及平均住院费用比较无显著差异(P0.05)。治疗组患者平均住院时间较对照组短,比较有统计学差异(P0.05)。6.两组胰腺脓肿及胰腺假性囊肿发生率比较均无显著差异(P0.05)。7.两组西医临床痊愈率、显效率、有效率比较均无显著差异(P0.05)。两组西医总体疗效比较无显著差异(P0.05)。治疗组的中医临床痊愈率比对照组显著升高(P0.05),两组显效率、有效率比较均无显著差异(P0.05)。两组中医总体疗效比较无显著差异(P0.05)。结论：注射用灯盏花素联合ERCP治疗ABP疗效确切,能改善ABP患者炎症反应和症状,促进胰腺功能的恢复,缩短住院时间的同时没有显著增加医疗费用,是联合传统中医药学和现代医学介入手段治疗ABP的新途径。
[Abstract]:Objective: to observe the clinical and experimental indexes of breviscapine combined with ERCP in the treatment of acute biliary pancreatitis, and to evaluate objectively the clinical efficacy of breviscapine combined with ERCP in the treatment of ABP, so as to provide a reliable basis and clinical basis for the treatment of ABP with integrated Chinese and western medicine. To promote the combination of traditional Chinese medicine and western medicine in the treatment of diseases. Methods: 77 cases of acute biliary pancreatitis were selected according to the study. According to the principle of parallel control design and random principle, the patients were divided into treatment group (group A), breviscapine combined with ERCP (group B) and control group (group B). Before and after treatment, serum TNF- 伪, IL-6, IL-8, IL-10, ETP, TBILT, ALP, 纬 -GT were measured before and after treatment. The level of AMY, the time of abdominalgia relief, the average cost of hospitalization, the incidence of pancreatic abscess, pancreatic pseudocyst and clinical curative effect were compared between the two groups, and the database was established and analyzed statistically. The result is 1: 1. After treatment, serum TNF- 伪, IL-6, IL-8 and IL-10 in both groups were significantly lower than those before treatment (P 0.05). After treatment, the levels of TNF- 伪 IL-6 and IL-8 in the treatment group were significantly lower than those in the control group. After treatment, the levels of serum ETH CRP in both groups were significantly lower than those before treatment (P 0.05). After treatment, the et and CRP of the two groups were significantly lower than that of the control group. On the 3rd and 7th day after treatment, the serum levels of TBILALP, 纬 -GT in both groups were significantly lower than those before treatment (P 0.05). There was no significant decrease of ALT in the two groups on the 3rd day after treatment compared with that before treatment, but on the 7th day after treatment, there was a significant decrease in P0.05U. There was no significant difference between the two groups in serum TBILA, ALP, 纬 -GT on the 3rd and 7th day after treatment. The serum amylase level in both groups was significantly lower than that before treatment at 12 h and 24 h after treatment for 3 d. There was no significant difference between the two groups at 12 h and 3 d after treatment (P 0.05). 24 hours after treatment, the treatment group was significantly lower than the control group (P 0.05). There was no significant difference in abdominalgia relief time and average hospitalization cost between the two groups (P 0.05). The average hospitalization time of the patients in the treatment group was shorter than that in the control group (P < 0.05). There was no significant difference in the incidence of pancreatic abscess and pancreatic pseudocyst between the two groups. There was no significant difference in the clinical cure rate, effective rate and effective rate between the two groups (P 0.05). There was no significant difference between the two groups in the overall curative effect of western medicine. The clinical cure rate of TCM in the treatment group was significantly higher than that in the control group (P 0.05). There was no significant difference in the effective rate and the effective rate between the two groups. There was no significant difference in total curative effect between the two groups (P 0.05). Conclusion: breviscapine combined with ERCP for injection is effective in the treatment of ABP. It can improve the inflammatory reaction and symptoms of ABP patients, promote the recovery of pancreatic function, and shorten the hospitalization time without significantly increasing the medical cost. It is a new way to combine traditional Chinese medicine and modern medical intervention in the treatment of ABP.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R576

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