CAJ | 학술논문

目的：观察中药复方淸胰汤对轻症急性胰腺炎（MAP）的临床疗效及对血清炎症因子水平的变化，并探讨中药复方淸胰汤治疗MAP的可能机制。方法对MAP患者随机分为两组，对照组采用单纯西医疗法，治疗组在西医治疗基础上给予清胰汤口服；另选健康者20例，作为正常对照组。取外周血检测血淀粉酶，并检测肿瘤坏死因子（TNF-α）、白介素-6（IL-6）、超敏C-反应蛋白（hs-CRP）。结果 MAP患者治疗组总有效率高于MAP患者对照组（P<0.05）。治疗第3天开始两组的血淀粉酶均较治疗前明显下降（P<0.05）；治疗第5天开始治疗组的血淀粉酶显著低于对照组（P<0.05）。治疗组患者腹痛、腹胀、排气、通便等症状和体征，以及血淀粉酶恢复正常的时间、住院时间均少于对照组（P<0.05）。对照组和治疗组治疗前的TNF-α、IL-6、hs-CRP水平较正常组均显著升高（P<0.05）；治疗7d后治疗组的TNF-α、IL-6、hs-CRP水平均显著低于治疗前，并显著低于同期对照组（P<0.05）。结论淸胰汤联合西医治疗MAP疗效较好，能减轻患者症状和体征，降低血淀粉酶，作用机制可能与抑制炎症因子释放及减轻炎症因子的级联瀑布效应有关。
목적：관찰중약복방청이탕대경증급성이선염（MAP）적림상료효급대혈청염증인자수평적변화，병탐토중약복방청이탕치료MAP적가능궤제。방법대MAP환자수궤분위량조，대조조채용단순서의요법，치료조재서의치료기출상급여청이탕구복；령선건강자20례，작위정상대조조。취외주혈검측혈정분매，병검측종류배사인자（TNF-α）、백개소-6（IL-6）、초민C-반응단백（hs-CRP）。결과 MAP환자치료조총유효솔고우MAP환자대조조（P<0.05）。치료제3천개시량조적혈정분매균교치료전명현하강（P<0.05）；치료제5천개시치료조적혈정분매현저저우대조조（P<0.05）。치료조환자복통、복창、배기、통편등증상화체정，이급혈정분매회복정상적시간、주원시간균소우대조조（P<0.05）。대조조화치료조치료전적TNF-α、IL-6、hs-CRP수평교정상조균현저승고（P<0.05）；치료7d후치료조적TNF-α、IL-6、hs-CRP수평균현저저우치료전，병현저저우동기대조조（P<0.05）。결론청이탕연합서의치료MAP료효교호，능감경환자증상화체정，강저혈정분매，작용궤제가능여억제염증인자석방급감경염증인자적급련폭포효응유관。
ObjectiveTo observe the clinical efficacy and inflammatory factors of“Qing Yi Tang” to mild acute pancreatitis,in order to explore the possible mechanism of Chinese medicine treatment of MAP. Methods68 cases of MAP were equally randomized to the control group and treated group all were treated with conventional Western medical therapy; but for patients in the treated group,“Qing Yi Tang” was given additionally. Besides,a group of 20 healthy persons was set up for normal control. Plasma levels of serum amylase,and tumor necrosis factor(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein (hs-CRP)were measured before and after treatment.ResultsThe total effective rate of the clinical efficacy in the treatment group was significantly better than the control group(P<0.05). The serum amylase in both groups were decreased significantly after 3 days,compared with before treatment(P<0.05); after 5 days,the blood amylase in treatment group was significantly lower than the control group(P<0.05). The abdominal pain,bloating,exhaust,bowelsopen and other symptoms and signs,as well as normal time of serum amylase restoration and hospitalization time were significantly less than the control group(P<0.05). The levels of TNF-α,IL-6 and hs-CRP were obviously higher before treatment as compared to those in the normal control group(P<0.05); which reduced markedly after treatment in both treated group and control group(P<0.05),but the changesin the treated group were more significant(P<0.05)after 7 days.Conclusion“Qing Yi Tang” combined Western medicine to treat mild acute pancreatitis show good effect,can significantly reduce the symptoms and signs,better reduce serum amylase,and its mechanism may be related to inhibition of inflammatory cytokine release,reduce inflammatory cytokines cascade waterfall.