联合大黄芒硝治疗重症急性胰腺炎的疗效及补体变化  

Effect of rhubarb combined with glauber＇s salt and the changes of complement in treatment of severe acute pancreatitis

作　　者：尚惺杰[1] 李红光[1] 张晓军[1] 任玲玲[1] 叶丽红[1] 

机构地区：[1]浙江省丽水市人民医院消化内科,浙江丽水323000

出　　处：《中国中西医结合急救杂志》2011年第6期344-346,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的 探讨联合大黄和芒硝治疗重症急性胰腺炎（SAP）的临床疗效及治疗前后补体的变化.方法 回顾性分析2005年1月至2011年3月本院收治的43例SAP患者的临床资料,将患者按随机原则分为观察组（24例）和对照组（19例）.对照组采用常规治疗;观察组在常规治疗基础上增加大黄水灌胃、芒硝敷腹.比较两组患者的疗效差异,同时监测治疗前后补体的变化.结果 与对照组比较,观察组患者腹痛和腹胀缓解时间（d：3.2±0.9比5.0±1.6）,肠鸣音恢复时间（d：4.2±1.5比7.5±3.1）、首次恢复排便时间（d：3.1±0.9比4.2±2.3）、禁食时间（d：7.9±1.1比11.5±2.6）、平均住院时间（d：15.8±3.2比21.5±4.8）均明显缩短（P＜0.05或P＜0.01）.两组治疗后补体C3、C4水平（g/L）均较治疗前明显下降（均P＜0.01）,但治疗后观察组略高于对照组（C3：1.25±0.17比1.23±0.11,C4：0.31±0.08比0.29±0.09,均P＞0.05）.结论 在常规治疗基础上联合大黄灌肠、芒硝敷腹能有效促进SAP患者胃肠功能恢复,调节机体免疫功能.Objective To explore the effect of rhubarb combined with glauber＇s salt and the changes of complement in the treatment of severe acute pancreatitis （SAP）. Methods Forty-three patients with SAP were retrospectively analyzed in our hospital from January 2005 to March 2011 and randomly divided into two groups： therapeutic group （24 eases） and control group （19 cases）. Both groups were treated by conventional treatment, and the therapeutic group was additionally treated by rhubarb intragastric infusion and the external application of glauber＇s salt on the abdomen. The therapeutic effects were compared between the two groups, and the changes of complement before and after treatment were monitored. Results Compared with the control group, in the therapeutic group, the remission time of the stomachache and abdominal distention （days ： 3.2 ± 0.9 vs. 5.0 ± 1.6）, the recovery time of bowel sound （days ： 4.2 4± 1.5 vs. 7.5 ± 3.1 ）, the first restoration of defecation time （ days ： 3.1 ± 0.9 vs. 4.2 ± 2.3 ）, fasting time （ days ： 7.9 ± 1.1 vs. 11.5 ± 2.6）, and average hospitalization time （days ： 15.8 ± 3.2 vs. 21.5 ± 4.8 ） were significantly shortened （P 〈 0.05 or P 〈 0.01 ） ; the complement C3 and C4 levels （g/L） after treatment were obviously lower than those before the treatment （all P 〈 0.01） in both groups, hut after treatment the levels in the therapeutic group were slightly higher than those in the control group （C3：1.25 ± 0.17 vs. 1.23 ± 0.11, C4：0.31 ± 0.08 vs. 0.29 ± 0.09, both P 〉 0.05）. Conclusions The conventional treatment combined with intragastrie rhubarb administration and glauber＇s salt external application on abdomen can effectively promote the recovery of gastrointestinal function and regulate the immune function in patients with SAP.

关 键 词：大黄 芒硝 胰腺炎 急性 重症 补体 中西医结合疗法 

分 类 号：R285.6[医药卫生—中药学] R657.5[医药卫生—中医学]