發(fā)布時間：2018-05-25 03:33

  本文選題：燈盞花素 + ERCP�。� 參考：《廣州中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的：觀察注射用燈盞花素聯(lián)合ERCP治療急性膽源性胰腺炎(ABP)的臨床和實驗指標(biāo),客觀評價其對ABP患者的臨床療效,為中西醫(yī)結(jié)合治療ABP提供可靠的基礎(chǔ)與臨床依據(jù),促進傳統(tǒng)中醫(yī)藥學(xué)與西醫(yī)先進技術(shù)結(jié)合治療疾病的進程。方法：以入住廣州軍區(qū)總醫(yī)院消化內(nèi)科并確診為急性膽源性胰腺炎的患者為研究對象,根據(jù)研究進行病例篩選,共77例。按照平行對照設(shè)計原理及隨機原則,將患者分為治療組(A組,燈盞花素聯(lián)合ERCP)和對照組(B組,ERCP)。測定治療前后血清TNF-α、IL-6、IL-8、IL-10、ET、CRP、TBIL、ALT、ALP、γ-GT. AMY的水平,觀察兩組患者腹痛緩解時間、平均住院時間、平均住院費用,比較兩組患者并發(fā)胰腺膿腫、胰腺假性囊腫發(fā)生率及臨床療效,建立數(shù)據(jù)庫,進行統(tǒng)計學(xué)分析。結(jié)果：1.兩組治療后血清TNF-α、IL-6、IL-8、IL-10均較治療前顯著下降(P0.05)。治療后,兩組的TNF-α、IL-6和IL-8分別比較,治療組均較對照組下降得更顯著(P0.05)。2.兩組治療后血清ET、CRP均較治療前顯著下降(P0.05)。治療后,兩組的ET和CRP分別比較,治療組均較對照組下降得更顯著(P0.05)。3.在治療后3天及7天,兩組的血清TBIL、ALP、γ-GT,均較治療前顯著下降(P0.05)。兩組ALT在治療后3天均較治療前無顯著下降(P0.05),在治療后7天均較治療前顯著下降(P0.05)。血清TBIL、ALT、ALP、γ-GT在治療后3天及7天,兩組比較均無顯著差異(P0.05)。4.在治療后12h、24h、3d,兩組血清淀粉酶均較治療前顯著下降(P0.05)。治療后12h及3d,兩組比較無顯著差異(P0.05)。治療后24h,治療組比對照組下降得更顯著(P0.05)。5.兩組腹痛緩解時間及平均住院費用比較無顯著差異(P0.05)。治療組患者平均住院時間較對照組短,比較有統(tǒng)計學(xué)差異(P0.05)。6.兩組胰腺膿腫及胰腺假性囊腫發(fā)生率比較均無顯著差異(P0.05)。7.兩組西醫(yī)臨床痊愈率、顯效率、有效率比較均無顯著差異(P0.05)。兩組西醫(yī)總體療效比較無顯著差異(P0.05)。治療組的中醫(yī)臨床痊愈率比對照組顯著升高(P0.05),兩組顯效率、有效率比較均無顯著差異(P0.05)。兩組中醫(yī)總體療效比較無顯著差異(P0.05)。結(jié)論：注射用燈盞花素聯(lián)合ERCP治療ABP療效確切,能改善ABP患者炎癥反應(yīng)和癥狀,促進胰腺功能的恢復(fù),縮短住院時間的同時沒有顯著增加醫(yī)療費用,是聯(lián)合傳統(tǒng)中醫(yī)藥學(xué)和現(xiàn)代醫(yī)學(xué)介入手段治療ABP的新途徑。
[Abstract]:Objective: to observe the clinical and experimental indexes of breviscapine combined with ERCP in the treatment of acute biliary pancreatitis, and to evaluate objectively the clinical efficacy of breviscapine combined with ERCP in the treatment of ABP, so as to provide a reliable basis and clinical basis for the treatment of ABP with integrated Chinese and western medicine. To promote the combination of traditional Chinese medicine and western medicine in the treatment of diseases. Methods: 77 cases of acute biliary pancreatitis were selected according to the study. According to the principle of parallel control design and random principle, the patients were divided into treatment group (group A), breviscapine combined with ERCP (group B) and control group (group B). Before and after treatment, serum TNF- 偽, IL-6, IL-8, IL-10, ETP, TBILT, ALP, 緯 -GT were measured before and after treatment. The level of AMY, the time of abdominalgia relief, the average cost of hospitalization, the incidence of pancreatic abscess, pancreatic pseudocyst and clinical curative effect were compared between the two groups, and the database was established and analyzed statistically. The result is 1: 1. After treatment, serum TNF- 偽, IL-6, IL-8 and IL-10 in both groups were significantly lower than those before treatment (P 0.05). After treatment, the levels of TNF- 偽 IL-6 and IL-8 in the treatment group were significantly lower than those in the control group. After treatment, the levels of serum ETH CRP in both groups were significantly lower than those before treatment (P 0.05). After treatment, the et and CRP of the two groups were significantly lower than that of the control group. On the 3rd and 7th day after treatment, the serum levels of TBILALP, 緯 -GT in both groups were significantly lower than those before treatment (P 0.05). There was no significant decrease of ALT in the two groups on the 3rd day after treatment compared with that before treatment, but on the 7th day after treatment, there was a significant decrease in P0.05U. There was no significant difference between the two groups in serum TBILA, ALP, 緯 -GT on the 3rd and 7th day after treatment. The serum amylase level in both groups was significantly lower than that before treatment at 12 h and 24 h after treatment for 3 d. There was no significant difference between the two groups at 12 h and 3 d after treatment (P 0.05). 24 hours after treatment, the treatment group was significantly lower than the control group (P 0.05). There was no significant difference in abdominalgia relief time and average hospitalization cost between the two groups (P 0.05). The average hospitalization time of the patients in the treatment group was shorter than that in the control group (P < 0.05). There was no significant difference in the incidence of pancreatic abscess and pancreatic pseudocyst between the two groups. There was no significant difference in the clinical cure rate, effective rate and effective rate between the two groups (P 0.05). There was no significant difference between the two groups in the overall curative effect of western medicine. The clinical cure rate of TCM in the treatment group was significantly higher than that in the control group (P 0.05). There was no significant difference in the effective rate and the effective rate between the two groups. There was no significant difference in total curative effect between the two groups (P 0.05). Conclusion: breviscapine combined with ERCP for injection is effective in the treatment of ABP. It can improve the inflammatory reaction and symptoms of ABP patients, promote the recovery of pancreatic function, and shorten the hospitalization time without significantly increasing the medical cost. It is a new way to combine traditional Chinese medicine and modern medical intervention in the treatment of ABP.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R576

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本文編號：1931911