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[目的]探讨自拟清下化瘀汤辅助治疗对重症急性胰腺炎(SAP)患者体液免疫及胃肠道功能的影响。[方法]将2012年1月~2014年6月我院收治的84例SAP患者随机分为观察组(n=42例)和对照组(n=42例),对照组给予常规西医治疗,观察组在常规治疗的基础上给予自拟清下化瘀汤治疗;检测2组患者治疗前及治疗后3、5、7d的血免疫球蛋白(IgG、IgA、IgM)、补体(C3、C4)、超敏C反应蛋白(hs-CRP)、血淀粉酶水平(AMY);同时记录患者急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、胃肠功能评分以及胃肠症状体征改善情况。[结果]与对照组比较,观察组在治疗后5、7d时IgG、IgM、C3、C4水平显著下调,而IgA显著增高(P<0.05);观察组治疗后5、7d的AMY、胃肠道功能评分、腹内压、APACHEⅡ及血浆hs-CRP亦显著低于对照组(P<0.05);观察组在胃肠道症状体征恢复方面亦优于对照组(P<0.05);观察组在治疗后5、7d后的总的治疗有效率显著高于对照组(P<0.05),而并发症低于对照组(P<0.05)。[结论]自拟清下化瘀汤辅助治疗重症急性胰腺炎可显著下调炎症水平、增强机体免疫功能,促进胃肠道功能恢复,临床疗效显著值得临床推广。
[Objective] To investigate the effects of self-made adjuvant Qingzhanghuayu decoction on humoral immunity and gastrointestinal function in patients with severe acute pancreatitis (SAP). [Methods] From January 2012 to June 2014, 84 SAP patients admitted to our hospital were randomly divided into observation group (n = 42) and control group (n = 42). The control group was given routine Western medical treatment and observed The patients in the two groups were treated with Qinghua Huayu decoction on the basis of routine treatment. The levels of serum immunoglobulin (IgG, IgA, IgM), complement (C3, C4) , Hs-CRP and AMY. Meanwhile, APACHEⅡ score, gastrointestinal function score and gastrointestinal symptoms and signs were also recorded. [Results] Compared with the control group, the levels of IgG, IgM, C3 and C4 in the observation group decreased significantly and the IgA increased significantly (P <0.05) at 5 and 7 days after treatment. The AMY and gastrointestinal The scores of pathological function, intra-abdominal pressure, APACHEⅡand plasma hs-CRP were also significantly lower than those of the control group (P <0.05). The observation group was also superior to the control group in gastrointestinal symptoms and signs recovery (P <0.05) The total effective rate after 5 and 7 days of treatment was significantly higher than that of the control group (P <0.05), while the complication rate was lower than that of the control group (P <0.05). [Conclusion] The self-made qingxiahuayu decoction adjuvant treatment of severe acute pancreatitis can significantly reduce the level of inflammation, enhance the body’s immune function and promote the recovery of gastrointestinal function, clinical efficacy worthy of clinical promotion.