Clinical study on Fuzheng Zhuyu Xiehuo Decoction combine with conventional western medicine therapy in the treatment of acute pancreatitis of intermingled blood stasis-toxin syndrome / 国际中医中药杂志

ABSTRACT

Objective:To explore the efficacy of Fuzheng Zhuyu Xiehuo Decoction for the patients with acute pancreatitis (AP) of intermingled blood stasis-toxin syndrome and its influence on peripheral blood inflammatory factors and microcirculation indicators.Methods:A total of 100 patients with AP, admitted to department of spleen and stomach diseases of the First Affiliated Hospital of Hunan University of Chinese Medicine and department of gastroenterology of the Central Hospital of Shaoyang, who met the inclusion criteria between March 2019 and March 2020, were divided into two groups according to the random number table method, with 50 in each group. The control group was given conventional western medicine, while the observation group was treated with Fuzheng Zhuyu Xiehuo Decoction on the basis of the control group. The TCM syndromes were scored before and after treatment, and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) was used to evaluate the severity of the disease, and ELISA was adopted to detect the levels of IL-6, IL-8, TNF-α and thromboxane A2 (TXA2), prostaglandin I 2 (PGI 2) and platelet activating factor (PAF). The abdominal pain, abdominal distension, fever, gastrointestinal function recovery time and hospital stay were observed and the adverse events were recorded. Results:The total effective rate was 96.0% (48/50) in the observation group and that of the control group was 84.0% (42/50) ( χ2=4.00, P=0.045). The scores of abdominal pain, abdominal distension, fever and nausea and vomiting in observation group were significantly lower than those in the control group ( t=7.07, 7.06, 11.47, 10.30, all Ps<0.01), and the recovery times of abdominal pain, abdominal distension, fever and gastrointestinal function and hospital stay in the observation group were significantly shorter than those in the control group ( t=4.52, 4.90, 6.27, 6.55, 7.12, all Ps<0.01). After treatment, the levels of serum IL-6 [(30.15±7.04) μg/L vs. (42.37±8.29) μg/L, t=7.95], IL-8 [(39.36±8.11) μg/L vs. (50.36±10.47) μg/L, t=5.87], TNF-α [(106.28±21.04) μg/L vs. (153.45±30.23) μg/L, t=9.06] in the observation group were significantly lower than those in the control group ( P<0.01). The serum TXA2 [(223.68±40.15) ng/L vs. (257.11±50.32) ng/L, t=3.67] and PAF [(74.86±15.37) ng/L vs. (85.53±15.26) ng/L, t=3.48] in the observation group were significantly lower than those in the control group ( P<0.01) while the level of PGI 2 [(91.43±17.45) ng/L vs. (76.49±15.13) ng/L, t=4.57] in the observation group was significantly higher than those in the control group ( P<0.01). Conclusion:Fuzheng Zhuyu Xiehuo Decoction combined with western medicine can improve clinical symptoms and blood microcirculation status, relieve inflammatory response and enhance clinical efficacy of patients with AP of intermingled blood stasis-toxin syndrome.