大柴胡汤对肝郁气滞型急性胰腺炎的炎症反应和氧化应激的影响

摘要

目的:探讨大柴胡汤联合两药常规治疗肝郁气滞型急性胰腺炎的疗效及作用机制.方法:急性肝郁气滞型胰腺炎患者146例,随机均分为对照组和观察组,对照组予以西药常规治疗,观察组在对照组的基础上加用大柴胡汤;观察两组患者的白细胞计数、血清淀粉酶、尿淀粉酶的恢复正常时间,同时观察影像学恢复正常时间和住院天数;于治疗前、治疗后第3天及第7天检测两组患者血清炎症反应指标[干扰素-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]和氧化应激指标[超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、丙二醛(MDA)].结果:观察组血淀粉酶、尿淀粉酶,白细胞计数及影像学恢复时间较对照组均明显缩短,差异有统计学意义(P＜0.05);观察组总住院时间明显短于对照组,差异有统计学意义(P＜0.05);治疗后第3天和第7天,观察组TNF-α、IL-6、IL-8及MDA的水平明显低于对照组,差异有统计学意义(P＜0.05);观察组SOD和CAT的水平明显高于对照组,差异有统计学意义(P＜0.05).结论:大柴胡汤联合常规西药治疗肝郁气滞型急性胰腺炎具有良好治疗效果,其机制可能与降低炎症因子水平和调节机体氧化应激能力有关.%Objective:To explore the effect and function mechanism of Dachaihu decoction in the acute pancreatitis patients of liver-qi stagnation type.Methods:From February 2015 to February 2017,146 patients with acute pancreatitis patients of liver-qi stagnation type in our hospital were selected,and randomly divided into the control group and study group.The control group was treated with Western medicine,while the study group added oral Dachaihu decoction.The white blood cell count,serum amylase,refectious normal time of amylase in urine as well as iconography and the length of stay in hospital were studied.The clinical indicators and serum levels of TNF-α、IL-6、IL-8 and SOD、CAT、MDA were detected in the two groups before treatment,on the 3rdand 7th days after treatment.Results:The amylase in blood and urine,WBC count and imaging recovery time of the observation group were significantly lower or shorter than those of the control group (P ＜0.05).In the hospitalization time,the observation group was also significantly shorter than the control group (P ＜ 0.05).On the third and seventh day after treatment,the levels of TNF-α,IL-6 and IL-8 in the observation group were significantly lower than those in the control group (P ＜ 0.05),and the levels of SOD and CAT were significantly higher than those in the control (P ＜ 0.05).The difference was statistically significant (P ＜0.05).Conclusion:Dachaihu decoction can significantly reduce acute pancreatitis inflammation levels in patients with liver-qi stagnation and adjust the ability of oxidative stress.This may be one of the important mechanisms in the treatment of acute pancreatitis.