大黄牡丹汤联合腹腔镜手术对急性阑尾炎患者免疫功能的影响
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摘要
[目的]观察大黄牡丹汤联合腹腔镜手术对急性阑尾炎患者免疫功能的影响。[方法]入选病例为2017年9月—2018年9月期间收治的84例急性阑尾炎患者,按随机数表法分成对照组(42例)与观察组(42例),两组均接受腹腔镜手术,对照组给予西药抗感染治疗,观察组服用中药大黄牡丹汤,比较两组临床疗效、肿瘤坏死因子-ɑ、C反应蛋白(CRP)、白介素-6(IL-6)、免疫功能及并发症。[结果]相比对照组,观察组治疗总有效率、CD_4~+、CD_4~+/CD_8~+均较高,TNF-α、CRP、IL-6、白细胞计数、中性粒细胞百分比、并发症发生率均较低,差异有统计学意义(P <0. 05)。[结论]急性阑尾炎患者采取大黄牡丹汤联合腹腔镜手术治疗可提高临床疗效,降低炎症反应,改善免疫功能,减少并发症发生。
[Objective]To observe the effect of Dahuang Mudan Decoction combined with laparoscopic surgery on immune function in patients with acute appendicitis. [Method]Eighty-four patients with acute appendicitis admitted to our hospital from September 2017 to September 2018 were selected and divided into control group( 42 cases) and observation group( 42 cases) according to random number table. Both groups received laparoscopic surgery. The control group was given anti-infection treatment with Western medicine. The observation group was given Dahuang Mudan Decoction. The clinical efficacy,TNF-ɑ,CRP,interleukin-6( IL-6) and immune functionof the two groups were compared. [Result]Compared with the control group,the total effective rate,CD_4~+ and CD_4~+/CD_8~+ of the observation group were higherwhile TNF-ɑ,CRP,IL-6,white blood cell count,neutrophil percentage and complication rate were lower( P <0. 05). [Conclusion]Dahuang Mudan Decoction combined with laparoscopic surgery for acute appendicitis can improve clinical efficacy and immune function and reduce inflammation and complications.
[Objective]To observe the effect of Dahuang Mudan Decoction combined with laparoscopic surgery on immune function in patients with acute appendicitis. [Method]Eighty-four patients with acute appendicitis admitted to our hospital from September 2017 to September 2018 were selected and divided into control group( 42 cases) and observation group( 42 cases) according to random number table. Both groups received laparoscopic surgery. The control group was given anti-infection treatment with Western medicine. The observation group was given Dahuang Mudan Decoction. The clinical efficacy,TNF-ɑ,CRP,interleukin-6( IL-6) and immune functionof the two groups were compared. [Result]Compared with the control group,the total effective rate,CD_4~+ and CD_4~+/CD_8~+ of the observation group were higherwhile TNF-ɑ,CRP,IL-6,white blood cell count,neutrophil percentage and complication rate were lower( P <0. 05). [Conclusion]Dahuang Mudan Decoction combined with laparoscopic surgery for acute appendicitis can improve clinical efficacy and immune function and reduce inflammation and complications.
引文
[1]肖国勇.大黄牡丹汤联合腹腔镜手术治疗急性阑尾炎的疗效及安全性分析[J].中医临床研究,2017,9(36):48-49.
[2]包小周,秦乐,林孝坤,等.大黄牡丹汤对腹腔镜手术后阑尾炎患儿炎症因子和免疫功能的影响[J].中医儿科杂志,2016,12(6):71-74.
[3]吴在德.外科学[M].北京:人民卫生出版社,2000:537-538.
[4]刘峰,陈振宙,薛立峰.急性阑尾炎的中医证型临床诊疗标准[J].中医临床研究,2018,10(15):91-93.
[5]国家中医药管理局.中医病证诊断疗效标准[S].北京:中国医药科技出版社,2012:129-132.
[6]姜明华.大黄牡丹汤加减联合腹腔镜阑尾切除术对急性阑尾炎患者术后胃肠功能及康复进程的影响[J].实用中西医结合临床,2018,18(1):92-93.
[7]黄文辉,林龙,黎明.腹腔镜下手术对急性阑尾炎患者体液免疫指标及炎性因子的影响[J].检验医学与临床,2017,14(15):2219-2221.
[8]李燕,赖泳.炎症细胞和细胞因子在肝纤维化中的作用研究进展[J].中国医院药学杂志,2018,38(18):109-113.
[9]孙传玮,李爱军,杨忠刚,等.血清C反应蛋白及补体C3水平与急性阑尾炎患儿预后相关性[J].创伤与急危重病医学,2018,6(3):36-37.
[10]杨录. IL-6、TNF-α在不同类型急性阑尾炎患者血清中的表达[J].青海医药杂志,2017,47(8):63-65.
[11]顾娴,朱颖茜.大黄牡丹汤保留灌肠联合血液净化治疗重症急性胰腺炎的临床效果及对肠黏膜屏障功能和炎症因子的影响[J].现代中西医结合杂志,2018,27(31):101-104.
[12]邢佑美.大黄牡丹汤保留灌肠治疗急性胰腺炎的临床效果分析[J].中国中医急症,2016,25(8):1634-1635.
[13]经结肠镜逆行阑尾炎治疗术专家共识制定小组.结肠镜结合中医药治疗阑尾炎专家共识(2016版)[J].微创医学,2017,23(4):6-7.
[14]于海艳,黄秀深,叶俏波,等.大黄牡丹汤的临床新用及研究进展[J].湖南中医杂志,2017,33(9):211-213.
[15]胡抢,孙元水,陈明显.大黄牡丹汤治疗阑尾炎术后临床疗效的meta分析[J].江西中医药大学学报,2017,29(2):41-45.
[16]邓芳芳,曹淼,张文兴.大黄牡丹汤恢复急性阑尾炎术后肠功能的Meta分析[J].中国中西医结合外科杂志,2015,21(2):124-127.
[17]汪雪,刘建,彭德伟,等.大黄牡丹汤联合腹腔镜治疗急性阑尾炎临床疗效观察[J].四川中医,2017,35(1):172-175.
[18]周健,高淳,唐学典.大黄牡丹汤加减治疗急性胰腺炎对机体炎症和应激反应的影响[J].中医药信息,2017,34(1):62-66.
[19]潘竟宏,张延英,汪永锋,等.大黄牡丹汤组方对急性胰腺炎模型大鼠胰腺微循环的影响[J].实验动物科学,2016,33(5):48-51.
[20]王宙.大黄牡丹汤对术后早期炎性肠梗阻的血清炎症因子(TNF-α,IL-6)的调控作用及机制探究[D].郑州:河南中医药大学,2017.
[2]包小周,秦乐,林孝坤,等.大黄牡丹汤对腹腔镜手术后阑尾炎患儿炎症因子和免疫功能的影响[J].中医儿科杂志,2016,12(6):71-74.
[3]吴在德.外科学[M].北京:人民卫生出版社,2000:537-538.
[4]刘峰,陈振宙,薛立峰.急性阑尾炎的中医证型临床诊疗标准[J].中医临床研究,2018,10(15):91-93.
[5]国家中医药管理局.中医病证诊断疗效标准[S].北京:中国医药科技出版社,2012:129-132.
[6]姜明华.大黄牡丹汤加减联合腹腔镜阑尾切除术对急性阑尾炎患者术后胃肠功能及康复进程的影响[J].实用中西医结合临床,2018,18(1):92-93.
[7]黄文辉,林龙,黎明.腹腔镜下手术对急性阑尾炎患者体液免疫指标及炎性因子的影响[J].检验医学与临床,2017,14(15):2219-2221.
[8]李燕,赖泳.炎症细胞和细胞因子在肝纤维化中的作用研究进展[J].中国医院药学杂志,2018,38(18):109-113.
[9]孙传玮,李爱军,杨忠刚,等.血清C反应蛋白及补体C3水平与急性阑尾炎患儿预后相关性[J].创伤与急危重病医学,2018,6(3):36-37.
[10]杨录. IL-6、TNF-α在不同类型急性阑尾炎患者血清中的表达[J].青海医药杂志,2017,47(8):63-65.
[11]顾娴,朱颖茜.大黄牡丹汤保留灌肠联合血液净化治疗重症急性胰腺炎的临床效果及对肠黏膜屏障功能和炎症因子的影响[J].现代中西医结合杂志,2018,27(31):101-104.
[12]邢佑美.大黄牡丹汤保留灌肠治疗急性胰腺炎的临床效果分析[J].中国中医急症,2016,25(8):1634-1635.
[13]经结肠镜逆行阑尾炎治疗术专家共识制定小组.结肠镜结合中医药治疗阑尾炎专家共识(2016版)[J].微创医学,2017,23(4):6-7.
[14]于海艳,黄秀深,叶俏波,等.大黄牡丹汤的临床新用及研究进展[J].湖南中医杂志,2017,33(9):211-213.
[15]胡抢,孙元水,陈明显.大黄牡丹汤治疗阑尾炎术后临床疗效的meta分析[J].江西中医药大学学报,2017,29(2):41-45.
[16]邓芳芳,曹淼,张文兴.大黄牡丹汤恢复急性阑尾炎术后肠功能的Meta分析[J].中国中西医结合外科杂志,2015,21(2):124-127.
[17]汪雪,刘建,彭德伟,等.大黄牡丹汤联合腹腔镜治疗急性阑尾炎临床疗效观察[J].四川中医,2017,35(1):172-175.
[18]周健,高淳,唐学典.大黄牡丹汤加减治疗急性胰腺炎对机体炎症和应激反应的影响[J].中医药信息,2017,34(1):62-66.
[19]潘竟宏,张延英,汪永锋,等.大黄牡丹汤组方对急性胰腺炎模型大鼠胰腺微循环的影响[J].实验动物科学,2016,33(5):48-51.
[20]王宙.大黄牡丹汤对术后早期炎性肠梗阻的血清炎症因子(TNF-α,IL-6)的调控作用及机制探究[D].郑州:河南中医药大学,2017.