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目的:探讨柴芩承气汤加减联合西医治疗对肠梗阻(IO)患者临床疗效、免疫功能及急性炎症反应的影响。方法:将486例肠梗阻患者随机分配为西医治疗组(对照组,n=243)与中西医结合治疗组(治疗组,n=243),对照组患者进行西医常规治疗,治疗组在对照组治疗基础上应用柴芩承气汤加减治疗。治疗前后检测并比较两组患者血清前蛋白(PA)、白蛋白(Alb)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、白细胞计数(WBC)、C反应蛋白(CRP)变化,比较患者T淋巴细胞亚群的比例、血浆二胺氧化酶(DAO)、乳果糖/甘露醇比值(L/M)变化。结果:治疗组临床疗效与临床症状改善显著高于对照组(P<0.05);治疗组治疗后PA、Alb指标显著提高(P<0.05),IL-6、IL-8、TNF-α、WBC、CRP指标显著降低(P<0.05);治疗组血浆DAO与L/M指标显著降低(P<0.05);与本组治疗前比较,治疗组患者血清CD4~+、CD8~+、CD4~+/CD8~+与Ig A、Ig G指标显著提高(P<0.05);与对照组同期比较,治疗组血清CD4~+、CD8~+、CD4~+/CD8~+与IgA指标显著提高,差异有统计学意义(P<0.05)。结论:柴芩承气汤加减联合西医治疗肠梗阻可以显著减轻患者炎症反应,改善免疫功能,修复胃肠道黏膜,疗效显著。
Objective: To investigate the effect of Chaiqin Chengqi decoction combined with western medicine on clinical curative effect, immune function and acute inflammatory reaction in patients with intestinal obstruction (IO). Methods: 486 patients with intestinal obstruction were randomly assigned to Western medicine treatment group (control group, n = 243) and Integrative Medicine group (treatment group, n = 243). Patients in control group were treated by western medicine routinely. Treatment based on the application of Chaiqin Chengqi Decoction treatment. The levels of serum prealbumin (PA), albumin (Alb), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α α, WBC and CRP were measured. The changes of T lymphocyte subsets, DAO and L / M were compared between the two groups. Results: The clinical curative effect and clinical symptom improvement in the treatment group were significantly higher than those in the control group (P <0.05). The PA and Alb indexes were significantly increased (P <0.05), IL-6, IL-8, TNF- (P <0.05). The plasma levels of DAO and L / M in the treatment group were significantly lower than those in the treatment group (P <0.05). Compared with the pretreatment group, the serum levels of CD4 +, CD8 +, CD4 + (P <0.05). Compared with the control group, the levels of CD4 ~ +, CD8 ~ +, CD4 ~ + / CD8 ~ + and IgA in the treatment group were significantly increased There was statistical significance (P <0.05). Conclusion: Chaiqin Chengqi Decoction combined with Western medicine treatment of intestinal obstruction can significantly reduce the inflammatory response, improve immune function, repair gastrointestinal mucosa, the curative effect is remarkable.