目的：分析基于“三才理论”的耳穴-外敷-灌肠组合治疗轻中型急性高脂血症性胰腺炎的疗效。方法：选择轻中型急性高脂血症性胰腺炎96例，按随机数字表法分为灌肠组(A组)、外敷⁺灌肠组(B组)以及外敷⁺灌肠⁺耳穴组(C组)3组，各32例。在常规治疗的基础上，A组采用柴芍承气汤灌肠；B组在A组基础上加用改良芒硝袋外敷；C组在B组基础上采用子午流注耳部全息刮痧⁺揿针埋针耳穴方案。分析治疗前后3组炎症指标血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、胃肠动力学(排气恢复、腹胀缓解、腹痛缓解、肠鸣音恢复、排便恢复)、肠黏膜功能(内毒素、二胺氧化酶)、免疫功能(CD3⁺、CD4⁺、CD8⁺)、临床相关指标[Ranson评分、PACHEⅡ评分、甘油三酯(TG)水平]。结果：炎症指标，C组TNF-α、hs-CRP低于其余两组(P<0.05)，而IL-6仅低于A组(P<0.05)，与B组比较差异无统计学意义(P>0.05)。胃肠功能恢复时间，3组腹胀缓解时间比较，差异无统计学意义(P>0.05)；在排气恢复、排便恢复时间及疼痛缓解时间，C组均显著少于其余两组(P<0.05)；肠鸣音恢复时间，C组明显低于A组(P<0.05)，与B组比较差异无统计学意义(P>0.05)。肠黏膜功能检测，C组内毒素、二胺氧化酶水平均低于其余两组(P<0.05)。免疫功能，C组CD3⁺、CD4⁺高于其余两组(P<0.05),CD8~+3组差异无统计学意义(P>0.05)。临床相关指标，C组Ranson评分、PACHEⅡ评分均低于其余两组，差异有统计学意义(P<0.05),TG水平C组低于A组(P<0.05)，与B组比较差异无统计学意义(P>0.05)。结论：基于“三才理论”的耳穴-外敷-灌肠组合方案治疗轻中型急性高脂血症性胰腺炎，可以降低炎症因子的表达，改善胃肠道功能，提高机体免疫力，疗效显著。

Objective:To analyze efficacy of the combination of “ear point-external application-enema”based on the “Sancai theory” on mild to moderate acute hyperlipidemic pancreatitis. Method:Totally,96 patients with mild to moderate acute hyperlipidemic pancreatitis were selected and randomly divided into three groups according to the number table method :enema group(group A),external application ⁺ enema group(group B),and external application ⁺ enema ⁺ ear point group(group C),32 patients in each group.Besides routine treatment,group A was further treated with enema by Chaishao Chengqi Decoction(柴芍承气汤 )；group B was further treated with external application of mirabilite bags based on the treatment in group A;group C was further treated with holographic scraping on the ear of midnight-noon ebb-flow and embedded pressing needle embedding in ear points based on the treatment in group B. Three sets of inflammatory indicators before and after treatment,serum tumor necrosis factor α(TNF-α),interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP),gastrointestinal dynamics(recovery of exhaust,relief of abdominal distension,relief of abdominal pain,recovery of bowel sounds,and recovery of defecation),intestinal mucosal function(endotoxin,diamine oxidase),immune function(CD3⁺,CD4⁺,CD8⁺),clinical related indicators[Ranson score,acute physiology and chronic health evaluation(PACHE) Ⅱ score,triglyceride(TG) level].Results:As to inflammatory markers,group C was lower than other two groups on levels of TNF-α and Hs-CRP(P<0.05),and was lower than group A(P<0.05) with no difference compared to group B(P>0.05)on IL-6. There was no statistically significant difference in the recovery time of gastrointestinal function and the relief time of abdominal distension among the three groups(P>0.05). The recovery time of bloating,defecation,and pain relief in group C were significantly shorter than those in other two groups(P<0.05).The recovery time of intestinal sounds in group C was significantly lower than that in group A(P<0.05),with no difference compared to group B(P>0.05). The intestinal mucosal function test showed that the levels of endotoxin and diamine oxidase in group C were lower than those in the other two groups(P <0.05). On immune function,levels of CD3⁺ and CD4⁺ in group C were higher than those in other two groups(P<0.05),and there was no statistically significant difference in CD8⁺ indicators among the three groups(P>0.05). On clinical related indicators,the Ranson score and PACHE Ⅱ score in group C were lower than other two groups,with statistical differences(P<0.05). The TG level in group C was lower than that in group A(P<0.05),with no difference compared to that in group B(P >0.05). Conclusions:The combined regimen of “ ear point-external application-enema ” based on “ Sancai Theory ” can reduce the expression of inflammatory factors,improve gastrointestinal function,and enhance immunity in the treatment of mild to moderate acute hyperlipidemic pancreatitis,with significant efficacy.