中国中西医结合外科杂志
中國中西醫結閤外科雜誌
중국중서의결합외과잡지
CHINESE JOURNAL OF SURGERY OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE
2014年
4期
346-349
,共4页
许文捷%朱培庭%高炬%钮宏文
許文捷%硃培庭%高炬%鈕宏文
허문첩%주배정%고거%뉴굉문
重症急性胰腺炎%肠内营养%炎性介质%锦红汤
重癥急性胰腺炎%腸內營養%炎性介質%錦紅湯
중증급성이선염%장내영양%염성개질%금홍탕
Severe acute pancreatitis%enteral nutrition%inflammatory mediators%Jinhong decoction
目的：探讨早期肠内营养联合锦红汤对重症急性胰腺炎患者血浆中炎性介质的影响。方法：选取2010年1月-2013年3月本院收治的60例SAP患者，随机分为肠外营养（PN）组（20例）、肠内营养（EN）组（20例）、锦红汤+EN组（20例）3组，分别测定治疗前1 d及治疗后3 d和8 d的血浆炎症介质TNF-α、IL-6、降钙素原、C-反应蛋白和血浆淀粉酶与脂肪酶的水平。结果：3组治疗后血浆各炎症介质及淀粉酶、脂肪酶均较治疗前明显改善（P＜0.05）。EN组治疗后3 d及8 d血浆IL-6、TNF-α、降钙素原、C-反应蛋白、淀粉酶、脂肪酶均较PN组显著降低（P＜0.05），锦红汤+EN组治疗后3 d、8 d血浆IL-6、TNF-a、降钙素原、C-反应蛋白、淀粉酶、脂肪酶亦均较PN组和EN组显著降低（P＜0.05）。结论：早期肠内营养联合锦红汤能降低重症急性胰腺炎患者血浆中炎性介质的水平，促进患者康复，具有一定的临床价值。
目的：探討早期腸內營養聯閤錦紅湯對重癥急性胰腺炎患者血漿中炎性介質的影響。方法：選取2010年1月-2013年3月本院收治的60例SAP患者，隨機分為腸外營養（PN）組（20例）、腸內營養（EN）組（20例）、錦紅湯+EN組（20例）3組，分彆測定治療前1 d及治療後3 d和8 d的血漿炎癥介質TNF-α、IL-6、降鈣素原、C-反應蛋白和血漿澱粉酶與脂肪酶的水平。結果：3組治療後血漿各炎癥介質及澱粉酶、脂肪酶均較治療前明顯改善（P＜0.05）。EN組治療後3 d及8 d血漿IL-6、TNF-α、降鈣素原、C-反應蛋白、澱粉酶、脂肪酶均較PN組顯著降低（P＜0.05），錦紅湯+EN組治療後3 d、8 d血漿IL-6、TNF-a、降鈣素原、C-反應蛋白、澱粉酶、脂肪酶亦均較PN組和EN組顯著降低（P＜0.05）。結論：早期腸內營養聯閤錦紅湯能降低重癥急性胰腺炎患者血漿中炎性介質的水平，促進患者康複，具有一定的臨床價值。
목적：탐토조기장내영양연합금홍탕대중증급성이선염환자혈장중염성개질적영향。방법：선취2010년1월-2013년3월본원수치적60례SAP환자，수궤분위장외영양（PN）조（20례）、장내영양（EN）조（20례）、금홍탕+EN조（20례）3조，분별측정치료전1 d급치료후3 d화8 d적혈장염증개질TNF-α、IL-6、강개소원、C-반응단백화혈장정분매여지방매적수평。결과：3조치료후혈장각염증개질급정분매、지방매균교치료전명현개선（P＜0.05）。EN조치료후3 d급8 d혈장IL-6、TNF-α、강개소원、C-반응단백、정분매、지방매균교PN조현저강저（P＜0.05），금홍탕+EN조치료후3 d、8 d혈장IL-6、TNF-a、강개소원、C-반응단백、정분매、지방매역균교PN조화EN조현저강저（P＜0.05）。결론：조기장내영양연합금홍탕능강저중증급성이선염환자혈장중염성개질적수평，촉진환자강복，구유일정적림상개치。
Objective To investigate the effect of plasma inflammatory mediators in the early enteral nutri-tion (EN) supplemented with Jinhong decoction in patients with severe acute pancreatitis (SAP). Methods Six-ty SAP cases were randomly assigned into parenteral nutrition (PN) group , enteral nutrition(EN) group and Jin-hong decoction added EN(J+EN) group .In J+EN group, patients were given their nutrition the same as that of EN, but added by Jinhong decoction .Blood samples were collected for the measurements of interleukin-6(IL-6) and tumor necrosis factor(TNF-α)by enzyme linked immunosorbent assay, and for C-reactive protein(CRP), pro-calcitonin(PCT), amylase and lipase by biochemical assay the day before intervention of nutrition and on the 3rd and 8th days after intervention. Results The plasma levels of inflammatory mediators, amylase and lipase were significantly reduced after nutritional intervention as compared with their levels on the day before interven-tion in all three groups. The plasma levels of IL-6, TNF-α, CRP, PCT, amylase and lipase in EN group were sig-nificantly less than those in PN group on the 3rd and 8th days. The plasma IL-6, TNF-α, CRP, PCT, amylase and lipase on the 3rd and 8th days after intervention of nutrition in J+EN group were significantly less than those in PN group and EN group. Conclusion Early EN with Jinhong decoction result in significant lowering of levels of pro-inflammatory cytokines and is valuable to the recovery of severe acute pancreatitis.
