| Objective:To evaluate the clinical therapeutic 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 serum thromboxane A2（TXA2）,prostaglandin（PGI2）,platelet activating factor（PAF）.To provide a theoretical evidence for the improvement of microcirculatory disturbance by TCM syndrome differentiation four couplets treatment.Method:90 AP patients who meet the inclusion were randomly divided into either a treatment group（traditional Chinese medicine syndrome differentiation four couplets treatment）or a control group.45 cases in control group were given routine treatment of Western Medicine（prohibiting eating,inhibition of pancreatic secretion,nutrition support,maintain the stability of the internal environment in the organism,if necessary,gastrointestinal decompression,when necessary,analgesic and sedative anti infection treatment）.On the basis of general western medicine treatment,45 cases of treatment group were treated with traditional Chinese medicine syndrome differentiation four couplets treatment,including lavage of Chinese Medicine:Chinese medicine decoction 100 ml,gastric tube slowly pour into,suspended gastrointestinal decompression 1H,1 times/4h;Chinese medicine retention enema:Chinese medicine decoction 200ml,1 times/6h;external application of Chinese medicine:with the Chinese medicine broken to pieces mixed with honey,then external application of the surface of the pancreas body projection,4h/times/day;Intravenous drip blood stasis drugs:breviscapine needle 100mg,add 5%glucose solution,intravenous drip,1times a day.Outcome measures:（1）the time of abdominal pain,abdominal distension disappeared and recovery of bowel sounds;（2）laboratory detection indexes:serum amylase,lipase,C-reactive protein,and leukocyte recovery to the normal range of the time;（3）the MCTSI score before and after treatment;（4）the changes of the serum TXA2,PAF,PGI2 level in patients before treatment and third,seventh,fourteenth days after treatment.Results:（1）The basic document of the two groups of patients were compared,including sex difference,age distribution,cause of disease,grade of disease severity and distribution of TCM syndromes,the difference between was not significant（P>0.05）.（2）In the treatment group,the disappearance time of abdominal pain and bowel sounds recovery time shorter than the control group,better than the control group;（P<0.05）,（3）the recovery time in treatment group of serum amylase,lipase,C-reactive protein and lipase returned is shorter than the control group,（P<0.05）;（4）the two groups after treatment MCTSI scores were all lower than before treatment,the treatment group MCTSI score lower than the control group;（P<0.05）;（5）the two groups of patients after treatment,serum TXA2,PAF concentration was significantly lower,while compared with the control group,the treatment group was significantly lower in third and seventh days of treatment;the concentration of PGI2 increased significantly,while in the treatment group,it was significantly higher than the control group after three and seven days treatment,（P<0.05）.There was no significant difference in TXA2,PAF and PGI2 concentrations between the two groups in the course of treatment for fourteenth days（P>0.05）.Conclusion1,Traditional Chinese medicine syndrome differentiation four couplets therapy can shorten the clinical symptoms disappeared and the signs returned to normal time of AP patients.2,TCM syndrome differentiation and quadruple therapy can shorten the time of serum amylase,lipase,C reactive protein and white blood cell recovery to normal range,and reduce the MCTSI score in patients with AP.3,TCM syndrome differentiation and quadruple therapy can reduce serum TXA2and PAF levels in patients with AP at an early stage,and increase the concentration level of PGI2. |
