柴芍承气汤在治疗重症胰腺炎合并感染中的作用  

Clinical efficacy of stomach tube BiSi wood que bearing gas soup in treatment of severe acute pancreatitis complicated with infections

作　　者：傅长来[1] 郑影影[1] 唐光华[1] 朱颖玲[1] 蒋丹斌[1] 吴红铃[1] 唐晓华[1] 王志祥[1] 杨勇[1] 

机构地区：[1]东南大学医学院附属盐城医院消化内科,江苏盐城224001

出　　处：《中华医院感染学杂志》2013年第13期3130-3132,共3页Chinese Journal of Nosocomiology

基　　金：江苏省盐城市基金项目(YK2011-108)

摘　　要：目的探讨经胃管鼻饲柴芍承气汤治疗重症胰腺炎合并感染的临床疗效,评价中药治疗重症胰腺炎的临床价值。方法选取56例重症胰腺炎合并感染患者,按照数字表格法随机分为对照组与治疗组各28例,两组均采取禁食水、胃肠减压、静脉营养支持、维持水及电解质及酸碱平衡、维持血糖稳定、抑酸、抗胰酶分泌、抗感染等综合治疗,对照组采取生长抑素(奥曲肽)0.1mg皮下注射,治疗组在对照组治疗基础上加用柴芍承气汤胃管注入,每次1剂,2次/d,观察两组患者治疗疗效。结果治疗组白细胞恢复时间、血淀粉酶恢复时间、尿淀粉酶恢复时间、肠鸣音恢复时间、排气时间、排便时间、腹痛消失时间、腹胀消失时间及住院时间分别为(5.73±2.80)d、(2.83±1.16)d、(6.49±3.20)d、(1.87±0.83)d、(8.12±2.21)d、(11.47±4.23)d、(5.12±2.85)d、(2.38±2.15)d、(15.86±4.27)d,对照组分别为(8.40±4.19)d、(4.25±1.26)d、(9.52±4.07)d、(4.82±3.14)d、(10.32±3.63)d、(15.40±5.82)d、(8.42±4.96)d、(6.84±3.69)d、(21.79±6.85)d,治疗组各项指标恢复时间明显短于对照组(P<0.05);治疗7d时治疗组总有效率为89.29%,对照组为57.14%,两组比较差异有统计学意义(P<0.05)。结论经胃管鼻饲柴芍承气汤治疗重症胰腺炎合并感染患者能快速改善患者肠道症状,提高了治疗疗效,具有较高的临床价值。OBJECTIVE To investigate the clinical curative effect of gastric tube BiSi wood Que bearing gas decoction in the treatment of severe acute pancreatitis complicated with infections and evaluate the clinical value of Chinese herbal medicine in treatment of severe acute pancreatitis.METHODS A total of 56cases of severe acute pancreatitis patients complicated with infections were enrolled in the study and were randomly divided into the control group and the treatment group according to digital form method with 28cases in each.All the patients in the two group were treated with fasting water,gastrointestinal decompression,parenteral nutrition support,maintaining water and electrolyte and acid-base balance,maintaining stable blood sugar,suppression of acid,resisting the pancreatic enzyme secretion,resistance to infection,and other comprehensive treatment measures,the control group was given the somatostatin（octretide）0.1mg subcutaneous injection,the treatment group,on the basis of the treatment in the control group,was treated with bavin Que bearing gas soup stomach tube injection,1agent once,and 2times per day,then the clinical therapeutic effect was observed between the two groups.RESULTS The leucocyte recovery time,blood amylase recovery time,urinary amylase recovery time,bowel sound recovery time,exhaust time,defecation time,abdominal pain disappear time,abdominal distension disappear time,and hospital stay were respectively（5.73±2.80）d,（2.83±1.16）d,（6.49±3.20）d,（1.87±0.83） d,（8.12±2.21）d,（11.47±4.23）d,（5.12±2.85）d,（2.38±2.15）d,and（15.86±4.27）dinthetreatmentgroup and were respectively（8.40±4.19） d,（4.25±1.26） d,（9.52±4.07） d,（4.82±3.14） d,（10.32±3.63） d,（15.40±5.82） d,（8.42±4.96） d,（6.84±3.69） d,and（21.79±6.85） d in the control group,the time of recovery of each index was significantly shorter in the treatment group than in the control group（P〈0.05）;the total effective rate of treatment on the seventh day was 89.29%i

关 键 词：柴芍承气汤 重症胰腺炎 感染 胃管鼻饲 

分 类 号：R181.32[医药卫生—流行病学]