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清胰汤预防内镜逆行胰胆管造影术后胰腺炎及高淀粉酶血症的效果

[Effect of qingyi decoction in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis and hyperamylasemia].

作者信息

Liu Cun-Gen, Leng Da-Yue, Liu Huan

机构信息

Hunan University of Traditional Chinese Medicine, Changsha.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009 Jul;29(7):607-10.

Abstract

OBJECTIVE

To explore the preventive effect of Qingyi Decoction (QYD) on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and hyperamylasemia.

METHODS

One hundred and twenty-five patients scheduled to receive ERCP were randomized by the digital table into three groups, two were medicated respectively with QYD (39 cases) and octreotide (42 cases), the other one was untreated for control (44 cases). Changes of blood levels of amylase, C-reactive protein (CRP), and interleukin-10 (IL-10), as well as the incidence of pancreatitis and hyperamylasemia was observed and compared.

RESULTS

The 4 h and 24 h post-operational blood amylase (U/L) was 132.03 +/- 75.29 and 153.15 +/- 78.69 in the QYD group, and 134.74 +/- 22.24 and 148.50 +/- 79.37 in the octreotide group, all were significantly lower than those in the control group (241.27 +/- 137.04 and 286.89 +/- 133.77), respectively. The 24 h CRP (mg/L) in both QYD and octreotide group (11.05 +/- 3.57 and 12.48 +/- 3.80) was also lower than that in the control group (17.70 +/- 4.93, P < 0.05), while the 24 h IL-10 (ng/L) in the QYD group (105.00 +/- 31.85) was higher than that in the octreotide group (77.98 +/- 33.13) and the control group (75.98 +/- 30.99) respectively. The incidence of pancreatitis in the QYD, octreotide, and the control group was 2.6%, 0 and 11.4%, that of hyperamylasemia in them 28.2%, 21.4%, and 56.8%, respectively. The occurrence rate of hyperamylasemia was lower in the QYD group and the octreotide group than in the control group (P < 0.05).

CONCLUSION

QYD could lower CRP and up-regulate IL-10 level, restrain the inflammation reaction and reduce the blood amylase level in the post-ERCP period, thus reducing the incidence of hyperamylasemia.

摘要

目的

探讨清胰汤(QYD)对内镜逆行胰胆管造影术(ERCP)后胰腺炎及高淀粉酶血症的预防作用。

方法

将125例计划接受ERCP的患者通过随机数字表法分为三组,两组分别给予清胰汤(39例)和奥曲肽(42例)治疗,另一组不进行治疗作为对照(44例)。观察并比较淀粉酶、C反应蛋白(CRP)、白细胞介素-10(IL-10)的血药浓度变化以及胰腺炎和高淀粉酶血症的发生率。

结果

清胰汤组术后4小时和24小时血淀粉酶(U/L)分别为132.03±75.29和153.15±78.69,奥曲肽组分别为134.74±22.24和148.50±79.37,均显著低于对照组(241.27±137.04和286.89±133.77)。清胰汤组和奥曲肽组24小时CRP(mg/L)(11.05±3.5及12.48±3.80)也低于对照组(17.70±4.93,P<0.05),而清胰汤组24小时IL-10(ng/L)(105.00±31.85)分别高于奥曲肽组(77.98±33.13)和对照组(75.98±30.99)。清胰汤组、奥曲肽组和对照组胰腺炎发生率分别为2.6%、0和11.4%,高淀粉酶血症发生率分别为28.2%、21.4%和56.8%。清胰汤组和奥曲肽组高淀粉酶血症发生率低于对照组(P<0.05)。

结论

清胰汤可降低CRP,上调IL-10水平,抑制ERCP术后炎症反应,降低血淀粉酶水平,从而降低高淀粉酶血症的发生率。

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