| Objective:To evaluate the clinical curative effect of the traditional Chinese medicine syndrome differentiation four couplets treatment to therapy acute pancreatitis(AP) and the effect of this combined method to the level of tumor necrosis factor-α(TNF-α),interleukin-8(IL-8), Interecllular cell adhesion molecule-1(ICAM-1).And further discusses the mechanism of this combined method in treatment of AP.Method: 83 AP patients who meet the inclusion criteria were randomly assigned to either a treatment group(traditional Chinese medicine dialectical four couplets treat ment group) or a control group(conventional western medicine treatment group). 40 patients of control group were treated with general internal medicine treatment, includi ng prohibiting eating, gastrointestinal decompression, fluid resuscitation, antishock, nutrition support, maintain water and electrolyte balance; proton pump inhibitors and somatostatin administration; pancreatic enzyme activity inhibitory drugs; antibiotic prophylaxis; analgesia, sedation,spasmolysis and other symptomatic treatments; respiratory support etc..) 43 patients of treatment group were not only treated with general internal medicine treatment, but also given chinese medicine lavage, rectal drip, topical and intravenous drip of proprietary Chinese medicine treatment. Chinese medicine lavage: patients were treated 100 ml fried fluid of Chinese medicine by intra gastric administration, and then clipped the stomach tubes to suspense the gastrointesti nal decompression 60 min, and patients were intragastric administration one time every four hours; retention enema: patients were treated 200 ml fried fluid of Chinese medicine, and one time every six hours; external application of the traditional Chinese medicine:applied the vaseline and chippings of traditional Chinese medicine mixture left flank and left flank of abdomen, and then bound up with lotus leaves, one time eve ry days; intravenous drip of proprietary Chinese medicine,and treatment for ten days. Observational index:(1) the time of abdominal pain and istension disappear;(2)the time of normal bowel sounds recovery;(3) the time of laboratory indexes(eg.serum amylase(AMS), lipase(LPS), leukocyte(WBC), C-reaction protein(CPR) returned to to normal;(4) the grade of MCTSI before and after treatment;(5)the concentration change of TNF-α, IL-8 and ICAM-1 of patients at prior treatment,and treatment of fifth or tenth day later.Results:(1) By comparing the basic situation of two groups of patients, there were no statistically significant difference in sex differences, age distribution, co ntributory factor of cause, and severity of illness between treatment group and control group(P>0.05).(2)asignificant fference was found between control group and treatment group in the time of abdominal pain and distension disappear, and time of normal bow-el sounds recovery, and the treatment group were superior to control group(P<0.05);(3) the recovery time of serum amylase, lipase, hemameba, and C-reaction protein of tr eatment group was faster than treatment group, and the treatment group were superior to control group(P < 0.05);(4) the grade of MCTSI of treatment group was lower than control group, and the differences had statistical significance(P<0.05); comparing with prior to treatment, a significant difference was found fin the concentration of TNF-α, IL-8 and ICAM-1 of patients after three and seven days treatment(P<0.05).Conclusion1,The traditional Chinese medicine syndrome differentiation four couplets treatment could shorten the patient’s abdominal pain and distension disappear time, and normal bowel sounds recovery time.2,The traditional Chinese medicine syndrome differentiation four couplets treatment could shorten the patient’s recovery time of AMS, LPS and CRP, and reduce the grade of MCTSI.3,The traditional Chinese medicine syndrome differentiation four couplets could alleviate inflammation of the AP patients by decreasing the concentration of TNF-α, IL-8 and ICAM-1 in blood serum. |
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