Jia Sailei, Chen Qian, Liu Xitong, Li Yanhong, Wang Lihui, Li Xian, Hu Shixiang
Department of Critical Care Medicine, Henan Provincial Hospital of Traditional Chinese Medicine, Henan University of Traditional Chinese Medicine, Zhengzhou, China.
Department of Critical Care Medicine, Henan Provincial Hospital of Traditional Chinese Medicine, The Second Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China.
Front Med (Lausanne). 2024 Oct 30;11:1429546. doi: 10.3389/fmed.2024.1429546. eCollection 2024.
Given the prevalent utilization of integrated traditional Chinese and western medicine (ITCWM) in the management of acute pancreatitis, the majority of studies have concentrated on severe cases, lacking robust evidence-based medical research. Real-world investigations can provide an objective assessment of the clinical effectiveness of combining traditional Chinese medicine with western medicine. Consequently, relying on real-world research, we intend to evaluate the clinical efficacy and safety of the combined approach in treating mild to moderate acute pancreatitis.
A total of 563 AP patients from Henan Provincial Hospital of Traditional Chinese Medicine were collected from January 2019 to October 2023. A propensity score matching (PSM) analysis was conducted to evaluate the clinical efficacy of traditional Chinese medicine (TCM) in treating mild to moderate acute pancreatitis. Patients were divided into a control group (61 cases) and an integrated traditional Chinese and Western medicine (ITCWM) group (120 cases). To further assess the clinical efficacy of TCM enema in the treatment of mild to moderate acute pancreatitis, PSM analysis was conducted across three groups. The patients were categorized into a control group ( = 49), an oral TCM treatment group (OCM group, = 274), and an oral TCM plus enema treatment group (OCM+E group, = 131). Logistic regression was used to analyze factors after treatment in each group, and the Kaplan-Meier method compared symptom duration in each group.
Compared with the control group, the ITCWM group significantly decreased C-reactive protein (CRP, mg/L) (17.8 [1.2-59.5] vs. 8.0 [3.3-33.5], = 0.022), shortened the duration of abdominal distension, abdominal pain, nausea and bitter taste symptoms ( < 0.05), and shortened the length of hospital stay (median 19.0 and 11.5 days, respectively, = 0.001); Compared with the other two groups, the neutrophil percentage (NEUT%) was lower (74.1 vs. 61.9 vs. 59.5, < 0.05) and serum prealbumin (PA, mg/L) was higher (116.0 vs. 184.4 vs. 220.0, < 0.05), the length of hospitalization (days) was shortened (19.0 vs.12.0 vs.10.0, < 0.05) in the OCM+E group.
The combination of traditional Chinese medicine and modern medicine has been shown to effectively decrease inflammatory indicators in patients with mild to moderate acute pancreatitis, leading to a reduction in symptom duration and hospitalization period, as well as promoting disease recovery. Notably, the use of traditional Chinese medicine in conjunction with enema therapy yields more pronounced benefits.
鉴于中西医结合疗法在急性胰腺炎治疗中的广泛应用，大多数研究集中在重症病例，缺乏有力的循证医学研究。真实世界研究能够对中西医结合的临床疗效进行客观评估。因此，基于真实世界研究，我们旨在评估中西医结合治疗轻至中度急性胰腺炎的临床疗效和安全性。
收集2019年1月至2023年10月河南省中医院的563例急性胰腺炎患者。进行倾向评分匹配（PSM）分析，以评估中医治疗轻至中度急性胰腺炎的临床疗效。患者分为对照组（61例）和中西医结合组（120例）。为进一步评估中药灌肠治疗轻至中度急性胰腺炎的临床疗效，对三组进行PSM分析。患者分为对照组（n = 49）、口服中药治疗组（OCM组，n = 274）和口服中药加灌肠治疗组（OCM+E组，n = 131）。采用逻辑回归分析各组治疗后的影响因素，并用Kaplan-Meier法比较各组症状持续时间。
与对照组相比，中西医结合组C反应蛋白（CRP，mg/L）显著降低（17.8[1.2 - 59.5]对8.0[3.3 - 33.5]，P = 0.022），腹胀、腹痛、恶心和口苦症状持续时间缩短（P < 0.05），住院时间缩短（中位数分别为19.0天和11.5天，P = 0.001）；与其他两组相比，OCM+E组中性粒细胞百分比（NEUT%）更低（74.1对61.9对59.5，P < 0.05），血清前白蛋白（PA，mg/L）更高（116.0对184.4对220.0，P < 0.05），住院时间（天）缩短（19.0对12.0对10.0，P < 0.05）。
中西医结合已被证明能有效降低轻至中度急性胰腺炎患者的炎症指标，缩短症状持续时间和住院时间，促进疾病恢复。值得注意的是，中药联合灌肠疗法效果更显著。
