健脾益气法对重症急性胰腺炎患者免疫功能、 炎症反应及肠道黏膜屏障功能的影响

Effects of strengthening the spleen and replenishing Qi on immune function, inflammatory response and intestinal mucosal barrier function in patients with severe acute pancreatitis

摘要:

目的 研究健脾益气法对重症急性胰腺炎患者免疫功能、炎症反应及肠道黏膜屏障功能的影响。 方法 选取2018 年12 月—2019 年7 月河北省沧州中西医结合医院收治的重症急性胰腺炎患者66 例，随机分 为实验组与对照组，每组33 例。对照组给予常规治疗；实验组常规治疗+ 健脾益气法治疗。观察两组患者疗效、 免疫功能、炎症反应、肠道黏膜屏障功能和中医证候评分、急性生理学与慢性健康状况评估Ⅱ（APACHE Ⅱ） 及Balthazar CT 评分。结果 实验组患者有效率高于对照组（P <0.05）。实验组患者治疗前后CD4+、CD4+/ CD8+ 及Treg 的差值低于对照组，而CD8+ 的差值高于对照组（P <0.05）。实验组患者治疗前后TNF-α、 IL-6 及CRP 的差值高于对照组（P <0.05）。实验组患者治疗前后血浆内毒素和血清DAO、D- 乳酸及淀粉 酶的差值高于对照组（P <0.05）。实验组治疗前后中医证候评分的差值高于对照组（P <0.05）。实验组患者 治疗前后APACHE Ⅱ、Balthazar CT 评分的差值高于对照组（P <0.05）。结论 重症急性胰腺炎患者采用健 脾益气方治疗疗效明显，可改善肠道黏膜屏障功能，提高机体免疫功能，减轻炎症反应。

Abstract:

Objective To investigate the effects of strengthening the spleen and replenishing Qi on immune function, inflammatory response and intestinal mucosal barrier function in patients with severe acute pancreatitis. Methods A total of 66 patients with severe acute pancreatitis admitted to our hospital from December 2018 to July 2019 were enrolled, and were randomly divided into two groups, each with 33 cases. Control group received routine treatment, and experimental group received routine treatment combined with strengthening the spleen and replenishing Qi treatment. The therapeutic efficacy, immune function, inflammatory response, intestinal mucosal barrier function, Traditional Chinese Medicine (TCM) syndrome score, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and Balthazar CT score were compared between groups. Results There was significant difference in clinical efficacy between the two groups (P < 0.05). The differences in levels of CD4+, CD4+/CD8+, and Treg cells before and after the treatment were greater in control group than those in experimental group (P < 0.05). However, the difference in CD8+ cells, TNF-α, IL-6, CRP, plasma endotoxin as well as serum DAO, D-lactic acid, and amylase levels before and after the treatment were greater in experimental group than those in control group (P < 0.05). Additionally, the differences in TCM syndrome score, APACHE Ⅱ and Balthazar CT scores were as well greater in experimental group than those in control group prior to and after treatment (P < 0.05). Conclusions Application of strengthening the spleen and replenishing Qi can effectively ameliorate the intestinal mucosal barrier function, improve the body’s immune function, and reducing the inflammatory response for patients with severe acute pancreatitis.