上海中医药杂志2026，Vol.60Issue(1)：57-63,7.DOI:10.16305/j.1007-1334.2026.z20250429003
芒硝外敷预防急性淋巴细胞白血病儿童二次门冬酰胺酶相关性胰腺炎的临床观察
Clinical observation of external application of mirabilite in preventing second asparaginase‑associated pancreatitis in children with acute lymphoblastic leukemia
摘要
Abstract
Objective To observe the clinical efficacy and safety of external application of mirabilite in preventing second asparaginase-associated pancreatitis(AAP)in children with acute lymphoblastic leukemia(ALL).Methods Fifty-four children with ALL who developed first-episode AAP and continued to receive ASP therapy were randomly divided into a treatment group(n=18)and a control group(n=36)at a 1∶2 ratio.The treatment group received external application of mirabilite starting on the day of ASP re-exposure,lasting for 2 weeks;the control group received no prophylactic interventions.The incidence of second AAP and safety of mirabilite external application were observed.Changes in serum pancreatic enzymes,inflammatory markers[interleukin(IL)-6,IL-10,C-reactive protein(CRP),and lactate dehydrogenase(LDH)],and liver function indicators[alanine transaminase(ALT),aspartate transaminase(AST),and total bilirubin(TBil)]were compared.Additionally,multivariate logistic regression analysis was used to identify risk factors for the development of second AAP.Results ① The incidence of second AAP was significantly lower in the treatment group(11.11%)than in the control group(44.44%),and the difference was statistically significant(P＜0.05).②Intragroup comparisons showed that LDH levels decreased in the treatment group after treatment(P＜0.05),while serum amylase,lipase,IL-6,ALT,AST,and TBil levels increased in the control group(P＜0.05).Post-treatment intergroup comparisons showed that the treatment group had lower levels of serum amylase,lipase,LDH,ALT,AST,and TBil than the control group(P＜0.05).③Multivariate logistic regression analysis showed that high serum TBil level after ASP re-exposure was an independent risk factor for the development of second AAP[HR=1.322,95%CI(1.06-1.66),P＜0.05].④ No adverse reactions related to external application of mirabilite were observed during the trial.Conclusions External application of mirabilite can prevent a second AAP in children with ALL,with easy operation and no obvious adverse reactions.Its mechanism may be associated with promoting bile excretion.关键词
急性淋巴细胞白血病/儿童/门冬酰胺酶/胰腺炎/芒硝/中药/临床研究Key words
acute lymphoblastic leukemia/children/asparaginase/pancreatitis/mirabilite/Chinese materia medica/clinical research引用本文复制引用
TANG Huijiao,ZHANG Tian'ao,DENG Zhaohui..芒硝外敷预防急性淋巴细胞白血病儿童二次门冬酰胺酶相关性胰腺炎的临床观察[J].上海中医药杂志,2026,60(1):57-63,7.基金项目
上海市科委2021年度"科技创新行动计划"医学创新研究专项(22Y11921800) （22Y11921800）
