大黄对合并呼吸衰竭重症胰腺炎的治疗作用及对IL-6、CRP 的影响

摘要

目的:观察大黄对合并呼吸衰竭重症胰腺炎(SAP)患者的治疗作用及对IL-6、CRP 的影响.方法:将56例入住ICU伴呼吸衰竭的SAP患者分为大黄治疗组和对照组,观察2 组患者氧合指数变化、机械通气天数、胃肠功能障碍持续时间、体温恢复时间及CRP、IL-6 的变化.结果:2 组患者第1、3天的血清CRP、IL-6水平相比无统计学差异(P＞0.05);第5 天血清CRP、IL-6 水平大黄治疗组低于对照组(P＜0.05),第7 天,2组比较有统计学差异(P＜0.01).第1、3、5、7天PaO2/FiO2 大黄治疗组高于对照组,2组相比有统计学差异(P＜0.05).大黄治疗组胃肠功能恢复所需时间与对照组比较,有统计学差异(P＜0.01);体温恢复时间大黄组与对照组相比,有统计学差异(P＜0.05);机械通气时间大黄治疗组与对照组比较有统计学差异(P＜0.01).结论:大黄可有效改善胃肠功能障碍并减弱炎症反应,抑制炎症因子释放,并能加速肺损伤的恢复,减少机械通气时间.%Objective: To approach therapeutic effects of DaHuang (Rhubarb) for patients with severe acute pancreatitis (SAP) complicated with respiratory failure and its impact on expressions of IL-6 and CRP. Method: All 56 patients were randomly divided into treatment group of DaHuang and control group. Changes of CRP and IL-6, recovery time of body temperature, duration of gastrointestinal disorder, days of mechanical ventilation and changes of oxygenation index of patients were observed. Result: Comparisons between both groups demonstrated no statistical difference in the levels of CRP and IL-6 in serum at the 1st and 3rd day (P>0.05); levels of CRP and IL-6 of treatment group were lower than that of control group at the 5th day (P<0.05), comparison between both groups at the 7th day showed statistical difference (P<0.01). Treatment group was higher than control group in PaO2/FiO2 at the 3rd, 5th and 7th day, comparisons between both groups had statistical difference (P<0.05). Comparisons between both groups showed significant difference in recovery time of gastrointestinal function (P<0.05); statistical difference also existed in time of mechanical ventilation (P<0.01). Conclusion: DaHuang could effectively improve gastrointestinal disorder, alleviate inflammatory reactions, inhibit the release of cytokines, accelerate the recovery of pulmonary injury and reduce the time of mechanical ventilation.