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急性胰腺炎早期中医药干预与机理探析

杨国红 赵文霞

引用本文:
Citation:

急性胰腺炎早期中医药干预与机理探析

DOI: 10.3969/j.issn.1001-5256.2018.04.006
详细信息
  • 中图分类号: R576

Early traditional Chinese medicine treatment of acute pancreatitis and its mechanism

  • 摘要:

    中医药在治疗急性胰腺炎(AP)中发挥着重要作用,介绍了中医药灌胃、灌肠、中药外敷、静脉点滴、针刺等多种治疗方法的有效性,指出在疾病早期应用中医药能有助于缓解临床症状、体征,减少并发症,降低病死率。分析认为分期辨证多途径联合治疗更符合AP的发病规律。表明中医药通过降低炎症因子水平、改善肠道功能和屏障、调节免疫功能、改善血液循环,以阻断炎症的进展,发挥治疗作用。

     

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