| Object:To summarize the medical records of 60 patients with chronic pancreatitis(CP),analyze the risk factors,symptoms,diagnosis,TCM syndromes and classification,treatment methods,etc.,to provide reference for Chinese medicine to participate in clinical treatment;And to observe and investigate the effects of continuous intervention of Ge Gen Qin Lian Decoction on intestinal p H,fecal elastin-1 and exocrine function in CP rats.Methods:1.To retrospectively analysis the 60 CP patients who were treated in the general surgery department of the Second Affiliated Hospital of Tianjin University of TCM and in the the First Biliary and Pancreatic Surgery department of Tianjin Nankai Hospital from January 2018 to January 2020,And to summarize the disease Risk factors,clinical symptoms and signs,complications,TCM syndrome types,treatment methods,etc.,evaluate the advantages of current imaging examinations,and analyze the correlation between tobacco and alcohol habits and clinical symptoms.2.Thirty healthy male Wistar rats were randomly divided into three groups,the control group,the model group,and the Ge Gen Qin Lian group each with 10 rats,The model group and Ge Gen Qin Lian group were fed with DBTC solution in the tail vein for 7 days to prepare CP models.then the rats in the Ge Gen Qin Lian group were administered with 1ml/100 g Ge Gen Qin Lian decoction suspension(0.4g/ml),and the other two groups were given the same volume of distilled water once a day for 21 consecutive days.After 3 weeks,the general and microscopic morphological changes of the pancreas in each group of rats were observed,and the intestinal p H and fecal elastin 1(FE-1)levels in each group were measured.Result:1.The major risk factors shown in 60 CP patients in this study include: long-term smoking(66.67%),long-term drinking(55.00%),biliary disease(48.33%),acute injury(35.00%),and abdominal surgery(30.00%),Hyperlipidemia(10.00%);4 cases were pancreas divisum(6.67%)and 3 were autoimmune pancreatitis(5.00%).There were 13 cases with two risk factors at the same time,accounting for 21.67% of the total number,10 cases with three risk factors(16.67%),and 15 cases with five risk factors,accounting for 25.00%.2.The main symptoms and signs were abdominal pain(55 cases,91.67%),of which 33 cases were intermittent(55%),16 cases were persistent(26.67%),and 17 cases(28.33%)were accompanied by radiation pain.;Other symptoms and signs include decreased appetite(51.67%),abdominal distension(50.00%),weight loss(50.00%),pancreatic diabetes mellitus or impaired glucose tolerance(41.67%),nausea(33.33%),fatigue(26.67%),belching(23.33%),constipation(16.67%),Diarrhea(11.67%),fatty diarrhea(1.67%),jaundice(5.00%);1 case without clinical manifestations.3.The complications of CP mainly include pancreatic pseudocyst(36.67%),Pleural or peritoneal effusion(25.00%),and common bile duct stricture(18.33%).Eight patients had two complications(accounting for 13.33% in total),three patients(5.00%)combined with three complications,and one patient had four complications including pseudocyst,common bile duct stricture,portal hypertension,and peritoneal effusion.4.Among the 60 CP patients in this study,31 cases(51.67%)have dampness-heat of spleen and stomach syndrome,11 cases(18.33%)have syndrome of liver qi invading stomach,8 cases of qi stagnation and blood stasis syndrome(16.33%),and 7 cases of spleen deficiency syndrome(11.67%),3 cases of asthenia-cold deficiency syndrome(5.00%).Among the manifestations of exocrine insufficiency,abdominal distension,decreased appetite,belching,diarrhea,and weight loss were most distributed in the spleen and stomach heat syndrome.5.Of the 60 CP patients,41 had abdominal B-ultrasounds(68.33%),with a positive detection rate of 80.49%;52 CT examinations(86.67%),a positive detection rate of 96.15%;24 MRI examinations(40.00%),positive The detection rate was 70.83%;38 cases(63.33%)were detected by MRCP,and the positive detection rate was 94.74%.Comparing the consistency of the ultrasound and CT,the consistency is fair(Kappa = 0.211,P<0.05);the difference between the two examinations shows that the CT positive detection rate(97.14%)is higher than ultrasound(80.00 %),The difference is statistically significant(P<0.05).6.In treatment,43 cases were treated with conservative drugs,accounting for 71.66%;1 case was interventional treatment(1.67%);16 cases were surgical treatment(26.67%).7.The percentage of pancreatic parenchymal changes and weight loss in the long-term smoking group(85.00%,67.50%)was higher than that in the non-smoker group(60.00%,25.00%),and the difference was statistically significant(P<0.05);The proportion of pancreatic duct morphology changes(62.50%)and pancreatic diabetes mellitus/impaired glucose tolerance(45.00%)were higher than those of non-smokers(65.00%,35.00%),but the difference was not statistically significant(P>0.05).The percentage of pancreatic parenchymal changes and pancreatic diabetes mellitus/impaired glucose tolerance(84.85%,45.45%)in the long-term drinking group was higher than that in the non-drinking group(66.67%,37.04%),and the difference was not statistically significant(P>0.05).The proportion of pancreatic duct morphological changes(61.64%)was lower than that of the non-drinking group(62.69%),the difference was not statistically significant(P>0.05).The proportion of weight loss(81.82%)was significantly higher than that of the nondrinking group(29.63%),the difference was statistically significant(P<0.05)8.Compared with the control group,the weight and FE-1 content of the rats in the CP model group were significantly reduced(P<0.05),the intestinal p H has a downward trend,but P>0.05,which was not statistically significant.Compared with the model group,the weight,intestinal p H,and FE-1 content of the rats in Ge Gen Qin Lian Decoction group were significantly increased(P <0.05).Conclusion:1.Alcohol became the main risk factor for chronic pancreatitis in this study,and smoking also became one of the important risk factors for chronic pancreatitis.2.The main TCM syndrome type of chronic pancreatitis in this study is dampness-heat of spleen and stomach syndrome.3.Patients with chronic pancreatitis who are long-term smokers are more likely to have pancreatic parenchymal changes.4.Patients with chronic pancreatitis with long-term tobacco and alcohol addiction are more likely to lose weight.5.Ge Gen Qin Lian Decoction can increase the intestinal p H of CP rats;6.Ge Gen Qin Lian Decoction has protective effect on exocrine function of CP rats. |
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