中西医治疗重症急性胰腺炎的研究进展

朱美冬; 罗运权

doi:10.3969/j.issn.1001-5256.2017.01.044

中西医治疗重症急性胰腺炎的研究进展

DOI: 10.3969/j.issn.1001-5256.2017.01.044

上海中医药大学附属曙光医院肝胆外科

详细信息

中图分类号: R576
计量
- 文章访问数: 2013
- HTML全文浏览量: 55
- PDF下载量: 410
- 被引次数: 0
出版历程
- 出版日期: 2017-01-20

Research advances in integrated traditional Chinese and Western medicine therapy for severe acute pancreatitis

Department of Hepatobiliary Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

摘要

摘要:
重症急性胰腺炎(SAP)是急性胰腺炎的特殊类型,常因误诊、误治而极易引起严重并发症,是临床上棘手的疾病之一。近年来,中西医结合治疗SAP已经有了大量的探索和进展,并出现了许多新亮点,在临床治疗方面显现出独特优势。然而,目前治疗SAP依旧沿用传统方法,有关治疗归类和文献整理的不足限制了其在临床治疗的效率和质量。从西医、中医角度分别整合归类现阶段SAP的有效治疗方式,以期为SAP临床治疗的发展提供参考。
- 胰腺炎 /
- 治疗 /
- 综述
Abstract:
Severe acute pancreatitis( SAP) is a special type of acute pancreatitis,and misdiagnosis and mistreatment can easily cause serious complications,which makes it a tough disease in clinical practice. In recent years,integrated traditional Chinese and Western medicine therapy for SAP has been explored and great progress has been achieved with several new highlights. It has special advantages in clinical treatment. However,conventional methods are still used for the treatment of SAP,and a lack of treatment classification and literature review limits its efficiency and quality in clinical treatment. This article summarizes the effective treatment modalities for SAP from the perspectives of Western medicine and traditional Chinese medicine,in order to provide a reference for the development in the clinical treatment of SAP.
- pancreatitis /
- therapy /
- review

HTML全文

参考文献(48)

[1]SARR MG,BANKS PA,BOLLEN TL,et al.The new revised classification of acute pancreatitis 2012[J].Surg Clin North Am,2013,93(3):549-562.

[2]CAMOVALE A,RABITTI PG,MANES G,et al.Mortality in acute pancreatitis:is it an early or a late event?[J].JOP,2005,6(5):438-444.

[3]WARNDORF MG,KURTZMAN JT,BARTEL MJ,et al.Early fluid resuscitation reduces morbidity among patients with acute pancreatitis[J].Clin Gastroenterol Hepatol,2011,9(8):705-709.

[4]ZHANG YQ,HUANG T,ER QD.Effects of controlled fluid resuscitation and simple fluid resuscitation on prognosis of patients with severe acute pancreatitis[J].Clin Med,2015,35(12):21-23.(in Chinese)张勇强,黄涛,尔启东.控制性液体复苏和单纯性液体复苏对重症急性胰腺炎患者治疗转归的影响[J].临床医学,2015,35(12):21-23.

[5]GU PP,CHEN YH,KE L,et al.An analysis of the effect of different ways of fluid resuscitation on the prognosis of patients with severe acute pancreatitis[J].China Med Pharm,2014,4(19):201-202,205.(in Chinese)顾萍萍,陈玉辉,柯路,等.不同液体复苏对重症急性胰腺炎患者预后的影响分析[J].中国医药科学,2014,4(19):201-202,205.

[6]XING B,ZHOU S,TAN SF,et al.Effects of different fluid resuscitation on hemodynamic parameters in patients with severe acute pancreatitis in early stage[J].Chin Gen Pract,2013,16(10B):3493-3496.(in Chinese)邢柏,周森,谭世峰,等.不同液体复苏对重症急性胰腺炎患者早期血流动力学的影响[J].中国全科医学,2013,16(10B):3493-3496.

[7]KUWABARA K,MATSUDA S,FUSHIMI K,et al.Early crystalloid fluid volume management in acute pancreatitis:association with mortality and organ failure[J].Pancreatology,2011,11(3):351-361.

[8]ZHENG S,TANG YM,YOU LY,et al.Effect of initial fluid resuscitation with different ratios of crystalloid-colloid on prognosis of patients with severe acute pancreatitis[J].Chin J Gastroenterol Hepatol,2013,22(12):1269-1272.(in Chinese)郑盛,唐映梅,尤丽英,等.不同晶胶比液体早期复苏对重症急性胰腺炎患者预后的影响[J].胃肠病学和肝病学杂志,2013,22(12):1269-1272.

[9]NAKAD A,PIESSEVAUX H,MAROT JC,et al.Is early enteral nutrition in acute pancreatitis dangerous?About 20 patients fed by an endoscopically placed nasogastrojejunal tube[J].Pancreas,1998,17(2):187-193.

[10]LIU LF,XIAO S,LI F,et al.Clinical reserch of early enteral nutrition at different time in patients with severe acute pancreatitis[J].Parenter Enteral Nutr,2011,18(5):263-265.(in Chinese)刘龙飞,肖帅,李峰,等.重症急性胰腺炎病人不同时机早期肠内营养治疗效果研究[J].肠外与肠内营养,2011,18(5):263-265.

[11]YAO HB,ZENG RC,WEN MB,et al.Comparation of therapeutic effects of early enteral nutrition and delayed enteral nutrition on severe acute pancreatitis[J].The J Pract Med,2014,30(14):2231-2233.(in Chinese)姚红兵,曾荣城,文明波,等.早期肠内营养与延迟肠内营养治疗重症急性胰腺炎的临床疗效比较[J].实用医学杂志,2014,30(14):2231-2233.

[12]NI J,YAN Q,YUAN WB,et al.Effects of timing of enteral nutrition in the severe acute pancreatitis[J].Clin J Dig Surg,2015,14(5):390-394.(in Chinese)倪俊,严强,袁文斌,等.肠内营养支持治疗时机选择对重症急性胰腺炎的作用[J].中华消化外科杂志,2015,14(5):390-394.

[13]van BAAL MC,KOHOUT P,BESSELINK MG,et al.Probiotic treatment with Probioflora in patients with predicted severe acute pancreatitis without organ failure[J].Pancreatology,2012,12(5):458-462.

[14]ZHANG LH,WANG J,SUN GJ,et al.Effects of early enteral nutrition in patients with severe acute inflammatory cytokine levels and immune function[J].J Hanan Med Coll,2015,21(6):758-761,765.(in Chinese)张立海,王娇,孙国娟,等.早期肠内营养对重症急性胰腺炎患者炎症细胞因子水平及免疫功能的影响[J].海南医学院学报,2015,21(6):758-761,765.

[15]FU Q,CUI NQ.Characteristics and treatment of organ impairment in early stage of severe acute pancreatitis[J].Chin J Surg Integr Tradit West Med,2010,16(2):151-154.(in Chinese)傅强,崔乃强.重症急性胰腺炎早期器官损害的特征及防治[J].中国中西医结合外科杂志,2010,16(2):151-154.

[16]PENG XJ,HUANG HF,CHEN WX,et al.Clinical efficacy of magnesium isoglycyrrhizinate in treatment of patients with severe acute pancreatitis[J].Chin J Clin Pharmacol,2015,31(14):1387-1389.(in Chinese)彭玄杰,黄慧峰,陈文晓,等.异甘草酸镁对重症急性胰腺炎患者的临床疗效研究[J].中国临床药理学杂志,2015,31(14):1387-1389.

[17]ZHONG Q,HUANG Z.The clinical research on the concurrent severe acute pancreatitis and multiple organ dysfunction and its prognosis[J].West China Med J,2012,27(4):527-529.(in Chinese)钟强,黄忠.重症急性胰腺炎并发多器官功能障碍及预后关系的临床研究[J].华西医学,2012,27(4):527-529.

[18]KONG FJ.Inhibition of ulinastatin on systematic inflammation of patients with severe acute pancreatitis[J].Shanxi Med J,2015,44(1):27-29.(in Chinese)孔繁静.乌司他丁对重症急性胰腺炎全身炎症反应的抑制作用及对疗效的影响[J].山西医药杂志,2015,44(1):27-29.

[19]ZHANG YH,PIAO XX.Observation of ulinastatin combined with somatostatin in treatment of severe acute pancreatitis[J].Modern Prevent Med,2011,38(21):4548-4549.(in Chinese)张彦宏,朴熙绪.乌司他汀联合生长抑素治疗重症急性胰腺炎疗效观察[J].现代预防医学,2011,38(21):4548-4549.

[20]ZHENG Q,WANG X,BAO XQ,et al.Effect of various doses of somatostatin on gastrointestinal motility and serum inflammatory factors in patients with severe acute pancreatitis[J].Chin J Med,2015,50(8):78-81.(in Chinese)郑强,王曦,鲍秀琦,等.不同剂量的生长抑素对重症急性胰腺炎患者的胃肠动力及血清炎症因子的影响[J].中国医刊,2015,50(8):78-81.

[21]LI KJ,XIANG ZG,CHEN XF,et al.Effect of early high-dose ulinastatin combined with octreotide therapy on inflammatory cytokines and T lymphocytes of patients with severe acute pancreatitis[J].J Hanan Med Coll,2015,21(7):929-932.(in Chinese)李科军,向正国,陈旭峰,等.早期大剂量乌司他丁联合奥曲肽治疗对重症急性胰腺炎患者炎症因子和T淋巴细胞的影响[J].海南医学院学报,2015,21(7):929-932.

[22]LIU DY,LEI LM,LIAO ZH,et al.Traditional Chinese medicine in treatment of acute pancreatitis[J].J Changchun Univ Chin Med,2015,31(4):877-880.(in Chinese)刘冬一,雷力民,廖昭海,等.中医药治疗急性胰腺炎研究进展[J].长春中医药大学学报,2015,31(4):877-880.

[23]LI SB,HUANG BZ,SHI LJ,et al.Research advances in traditional Chinese medicine treatment of severe acute pancreatitis[J].Mod J Integr Tradit Chin West Med,2012,21(14):1593-1596.(in Chinese)李树标,黄波贞,石罗君,等.重症急性胰腺炎的中医药治疗进展[J].现代中西医结合杂志,2012,21(14):1593-1596.

[24]CAI L,LI G,ZHAO JF,et al.Therapeutic effect of Qingyi decoction on changes of inflammatory factor in rat serum with severe acute pancreatitis[J/CD].Chin J Crit Care Med:Electronic Edition,2013,6(6):35-38.(in Chinese)蔡玲,李钢,赵金峰,等.清胰汤对大鼠重症急性胰腺炎炎症反应的影响[J/CD].中华危重症医学杂志:电子版,2013,6(6):35-38.

[25]ZHONG J,LIU L,LIU DS,et al.Mechanism of Taohechengqi decoction on inflammatory factors in severe acute pancreatitis rat model[J].Chin J Gerontol,2015,35(12):3223-3226.(in Chinese)钟健,刘丽,刘大晟,等.桃核承气汤对重症急性胰腺炎模型大鼠炎症因子的调控作用及机制[J].中国老年学杂志,2015,35(12):3223-3226.

[26]GAO C.A clinical analysis of treating severe acute pancreatitis in the integrative medicine[J].Clin J Chin Med,2015,7(2):119-120.(in Chinese)高超.清胰通腑泄热消胀法与西医结合治疗重症急性胰腺炎的疗效分析[J].中医临床研究,2015,7(2):119-120.

[27]GUO YZ,WANG JH,LI XT,et al.Efficacy of Qingyitang and red peony root combined with enteral nutrition on severe acute pancreatitis[J].Chin J Diffic and Compl Cas,2013,12(1):32-34.(in Chinese)郭永泽,王建华,李校天,等.赤芍加清胰汤联合空肠营养治疗重症急性胰腺炎35例临床观察[J].疑难病杂志,2013,12(1):32-34.

[28]ZHANG XM,MA PA,SUN JW,et al.Effect of Qingyi Chengqi decoction on severe acute pancreatitis patients:a clinical study[J].Chin J Integr Tradit West Med,2014,34(1):31-34.(in Chinese)张小明,马平安,孙建伟,等.清胰承气汤治疗重症急性胰腺炎患者的临床研究[J].中国中西医结合杂志,2014,34(1):31-34.

[29]XUE QM,HUANG L,LI N.Effects of electroacupuncture at Tianshu(ST25)on pro-and anti-inflammatory cytokines in rats with severe acute pancreatitis[J].J Chin Integr Med,2011,9(6):658-664.(in Chinese)薛奇明,黄露,李宁.电针天枢穴对重症急性胰腺炎大鼠血清促炎和抗炎因子的影响[J].中西医结合学报,2011,9(6):658-664.

[30]TIAN BN,HE JH,HUANG M.Effect of octretide and breviscapine on blood rheology and serum inflammatory factors in patients with severe acute pancreatitis[J].J Clin Med Pract,2015,19(17):38-40.(in Chinese)田邦妮,贺建华,黄梅.奥曲肽联合灯盏花素对重症急性胰腺炎患者血液流变学、血清炎症因子的影响及疗效研究[J].实用临床医药杂志,2015,19(17):38-40.

[31]XU J.Clinical effect of Chaishao Chengqi decoction combined with somatostatin in treatment of severe acute pancreatitis[J].Guide China Med,2016,14(11):203-204.(in Chinese)徐静.柴芍承气汤联合生长抑素在重症急性胰腺炎治疗中的应用价值分析[J].中国医药指南,2016,14(11):203-204.

[32]BRADLEY EL 3rd,DEXTER ND.Management of severe acute pancreatitis:a surgical odyssey[J].Ann Surg,2010,251(1):6-17.

[33]WANG SY,XUE HZ,JIANG QF,et al.Clinical observation of surgical treatment of severe acute pancreatitis:a report of 43 cases[J].J Medical Forum,2015,36(2):74-75,78.(in Chinese)王淑一,薛焕洲,姜青峰,等.重症急性胰腺炎外科治疗的临床观察[J].医药论坛杂志,2015,36(2):74-75,78.

[34]LIU DT,LUO CM,LI B,et al.The effect of different therapeutic schemes for acute biliary pancreatitis patients with inflammatory cytokines and medical burden[J].Lab Med Clin,2013,10(13):1662-1663.(in Chinese)刘东涛,罗春梅,李兵,等.不同治疗方案对急性胆源性胰腺炎患者炎症因子及医疗负担的影响[J].检验医学与临床,2013,10(13):1662-1663.

[35]RANSON JH,SPENCER FC.The role of peritoneal lavage in severe acute pancreatitis[J].Ann Surg,1978,187(5):565-575.

[36]WU YL,LU BY.Study on the therapeutic effect of interrupted peritoneal lavage combined with antibiotics on severe acute pancreatitis in rats[J].J Minim Invas Med,2012,7(5):457-462.(in Chinese)吴裕林,卢榜裕.早期间断腹腔灌洗联合抗生素对重症急性胰腺炎大鼠的影响[J].微创医学,2012,7(5):457-462.

[37]GONG JH.Study on the clinical effects of peritoneal catheter drainage combined with antibiotics in the treat-ment for severe acute pancreatitis[J].Med Recapitulate,2015,21(8):1517-1519.(in Chinese)龚进红.腹腔置管引流联合抗生素治疗重症急性胰腺炎的临床疗效评价[J].医学综述,2015,21(8):1517-1519.

[38]LAN DT,YANG H.Clinical application of antibiotics in severe acute pancreatitis[J].Clin Ration Drug Use,2010,3(3):56.(in Chinese)兰戴天,杨皓.抗生素在重症急性胰腺炎中的应用[J].临床合理用药,2010,3(3):56.

[39]YU R,ZHANG LF,ZHANG SH,et al.Clinical effect of abdominal cavity catheter drainage combined with lavage with antibiotics in treatment of severe acute pancreatitis[J].China J Prac Med,2012,39(8):81-82.(in Chinese)于蕊,张连峰,张守恒,等.腹腔置管引流联合抗生素灌洗治疗重症急性胰腺炎[J].中国实用医刊,2012,39(8):81-82.

[40]ABRAHAM P,RODRIQUES J,MOULICK N,et al.Efficacy and safety of intravenous ulinastatin versus placebo along with standard supportive care in subjects with mild or severe acute pancreatitis[J].J Assoc Physicians India,2013,61(8):535-538.

[41]DU J.Efficacy of regional intra-arterial and intravenous Ulinastatin in treating severe acute pancreatitis and its influence on inflammatory stress reaction[J].J Hanan Med Coll,2014,20(12):1636-1638,1641.(in Chinese)杜江.区域动脉灌注和静脉注射乌司他丁对重症急性胰腺炎的疗效及对机体炎症应激反应的影响[J].海南医学院学报,2014,20(12):1636-1638,1641.

[42]CHEN J,LUO HS.Meta analysis of CVVH for severe acute pancreatitis[J].Chin J Gastroenterol Hepatol,2012,21(3):284-288.(in Chinese)陈娟,罗和生.连续性血液滤过治疗急性重症胰腺炎的Meta分析[J].胃肠病学和肝病学杂志,2012,21(3):284-288.

[43]MAO EQ,TANG YQ,HAN TQ,et al.Effects of short veno-venous hemofiltration on severe acute pancreatitis[J].Chin J Surg,1999,37(3):141-143.(in Chinese)毛恩强,汤耀卿,韩天权,等.短时血滤对重症急性胰腺炎治疗的影响[J].中华外科杂志,1999,37(3):141-143.

[44]LIANG XL,SHI W,LIANG YZ,et al.Effects comparison of short-term,high-volume hemofiltration therapy and intermittent hemodialysis on severe pancreatitis patients with acute renal failure[J].Chin J Blood Purif,2003,2(7):366-368.(in Chinese)梁馨苓,史伟,梁永正,等.短时高容量血液滤过与间歇性血液透析治疗重症胰腺炎的疗效比较[J].中国血液净化,2003,2(7):366-368.

[45]LIAO Q,ZHAO YP.Timing of surgical intervention for severe acute pancreatitis[J].Chin J Pract Surg,2012,32(7):584-586.(in Chinese)廖泉,赵玉沛.重症急性胰腺炎外科干预时机选择[J].中国实用外科杂志,2012,32(7):584-586.

[46]HUANG K.Clinical effect of surgical treatment of severe acute pancreatitis:an analysis of 62 cases[J].Chin J Etho Med Ethnopharm,2013,22(21):68.(in Chinese)黄克.62例重症急性胰腺炎的外科手术疗效分析[J].中国民族民间医药,2013,22(21):68.

[47]ZHANG YL.Clinical effect of surgical versus conservative treatment of severe acute pancreatitis and prognostic analysis[J].World Latest Med Inform,2015,15(35):63.(in Chinese)张跃林.重症急性胰腺炎的外科治疗与保守治疗的疗效与预后分析[J].世界最新医学信息文摘,2015,15(35):63.

[48]LIN ZW,CHANG ZG,WEI JM,et al.Treatment of severe acute pancreatitis and the timing of surgical intervention:a multicenter retrospective study[J].Chin J Pract Surg,2012,32(7):561-564.(in Chinese)林泽伟,常志刚,韦军民,等.重症急性胰腺炎治疗方式与外科处理时机的选择(多中心回顾性研究)[J].中国实用外科杂志,2012,32(7):561-564.

施引文献

资源附件(0)

访问统计