关键词:

急性胰腺炎, 重症, 中医证型, 病情转归

Abstract:

Objective　To analyze the distribution of traditional Chinese medicine syndrome types in acute severe pancreatitis, and to explore the relationship between traditional Chinese medicine syndrome types and disease outcomes. Methods　A retrospective analysis was conducted on the clinical data of 107 patients with acute severe pancreatitis admitted to First Hospital, Henan University of Chinese Medicine from May 2018 to April 2023. The distribution of traditional Chinese medicine syndrome types and their prognosis 14 days after admission were statistically analyzed. χ² and t tests were used. The Cox regression analysis model was used for the multivariate analysis. Results　The proportion of the traditional Chinese medicine syndrome types in the 107 patients from high to low were visceral excess heat syndrome (39.25%, 42/107), liver and gallbladder dampness heat syndrome (30.84%, 33/107), stasis and toxin combined syndrome (18.69%, 20/107), internal closure and external detachment syndrome (10.28%, 11/107), and liver depression and qi stagnation syndrome (0.93%, 1/107). There were no statistical differences in gender and age distributions between the patients of different syndrome types (both P>0.05), while there was a statistical difference in the distribution of causes between the patients of different syndrome types (χ²=64.08, P<0.001). The incidence of exacerbation in the patients with severe acute pancreatitis was 19.63% (21/107). The results of multivariate Cox regression analysis showed that stasis and toxin combined syndrome [risk ratio (HR)=5.307, 95% confidence interval (95%CI) 1.394-20.2015, P=0.014], internal closure and external detachment syndrome (HR=7.941, 95%CI 2.204-28.614, P=0.001), acute physiology and chronic health evaluation Ⅱ score at admission (HR=1.384, 95%CI 0.732-2.617, P=0.008), and Ranson score at admission (HR=1.639, 95%CI 1.165-2.305, P=0.005) were risk factors for the exacerbation of the patients with acute severe pancreatitis. Conclusions　The main traditional Chinese medicine syndrome of patients with acute severe pancreatitis is visceral excess heat syndrome; stasis and toxin combined syndrome and internal closure and external detachment syndrome are the influencing factors for their prognosis.

Key words:

Acute pancreatitis, Severe cases, Traditional Chinese medicine syndrome types, Disease outcomes