生大黄及甘露醇治疗急性胰腺炎的比较研究  

A Comparative Study of Rhubarb and Mannitol Used in the Treatment of Acute Pancreatitis

作　　者：常瑞[1,3] 潘屹[2] 曾宪策 CHANG Rui;PAN Yi;ZENG Xian-ce(Chongqing Hospital of Traditional Chinese Medicine and Orthopaedics,Chongqing 400012;Department of General Surgery,Chongqing Ninth People’s Hospital,Chongqing 400700;Chongqing Orthopaedic Hospital of Traditional Chinese Medicine,National Famous Old Chinese Medicine Expert Zeng Xiance Inheritance Studio,Chongqing 400012)

机构地区：[1]重庆市中医骨科医院,重庆400012 [2]重庆市第九人民医院普外一科,重庆400700 [3]重庆市中医骨科医院全国名老中医药专家曾宪策传承工作室,重庆400012

出　　处：《世界最新医学信息文摘》2021年第27期199-200,202,共3页World Latest Medicine Information Electronic Version

基　　金：全国(基层)名老中医药专家传承工作室建设项目[国中医药人教函[2018]134号]。

摘　　要：目的探讨生大黄及甘露醇用于急性胰腺炎疗效的差异性.方法回顾重庆市第九人民医院普外一科2018年1月至2019年12月期间收治急性胰腺炎患者共计384例,其中采用标准治疗方案联合生大黄灌胃或甘露醇灌胃治疗患者共119例,其中行标准治疗方案联合生大黄66例(生大黄组),标准治疗方案联合甘露醇53例(甘露醇组),分别统计:腹痛消失时间、腹胀消失时间、血淀粉酶恢复正常时间、首次肛门排气时间、腹部压痛消失时间、患者住院时间等,通过统计学分析并探讨两种治疗方案疗效的差异性.结果两组患者腹胀消失时间及首次肛门排气时间有统计学差异(腹胀消失时间Z=-2.568,P=0.010,首次肛门排气时间Z=-2.135,P=0.033),生大黄组优于甘露醇组.两组腹痛消失时间无统计学差异(Z=-1.479,P=0.139)、血淀粉酶恢复正常时间无统计学差异(Z=-1.251,P=0.211)、腹部压痛消失时间无统计学差异(Z=-1.479,P=0.139)、患者住院时间无统计学差异(Z=-0.366,P=0.714).结论标准治疗方案联合生大黄灌胃与联合甘露醇灌胃治疗急性胰腺炎的总体疗效差异不明显,但在促进肠道功能恢复、减轻腹胀疗效方面,生大黄优于甘露醇.因此,对于腹胀较明显的急性胰腺炎患者,我们建议优先选择联合使用生大黄治疗.Objective To discuss the differences in the efficacy of rhubarb and mannitol for acute pancreatitis.Methods The study carried out a review of 384 patients with acute pancreatitis admitted to the Department of General Surgery,Chongqing Ninth People's Hospital from January 2018 to December 2019,including 119 patients treated with standard treatment regimen combined with rhubarb or mannitol gavage.Among them,there were 66 cases of standard treatment regimen combined with rhubarb(raw rhubarb group),53 cases of standard treatment regimen combined with mannitol(mannitol group),and the statistics were counted respectively:disappearance time of abdominal pain,disappearance time of abdominal distension,recovery time of blood amylase,first time of anal exhaust,disappearance time of abdominal tenderness,patient hospitalization time,etc.The difference of curative effect between the two treatments was analyzed through statistical analysis.Results There was a statistically significant difference between the two groups in the disappearance time of abdominal distension and the first anal exhaust time(disappearance time of abdominal distension Z=-2.568,P=0.010,first anal exhaust time Z=-2.135,P=0.033),and the rhubarb group was better than mannitol group.There was no significant difference in the disappearance time of abdominal pain(Z=-1.479,P=0.139),the recovery time of blood amylase(Z=-1.251,P=0.211),the disappearance time of abdominal tenderness(Z=-1.479,P=0.139),and hospital stay(Z=-0.366,P=0.714),between the two groups.Conclusion There was no significant difference in the overall efficacy of the standard treatment regimen combined with rhubarb gavage and with mannitol gavage in the treatment of acute pancreatitis,but rhubarb was superior to mannitol in promoting intestinal function recovery and reducing abdominal distension.Therefore,for patients with acute pancreatitis with obvious abdominal distension,we recommend that the combination of raw rhubarb treatment should be preferred.

关 键 词：生大黄 甘露醇 急性胰腺炎 疗效 

分 类 号：R657.51[医药卫生—外科学]