复方大柴胡汤联合十二指肠镜治疗对急性胆源性胰腺炎患者临床预后的影响  

THE EFFECT OF CHINESE MEDICINE "DA CHAI HU TANG" ASSOCIATE WITH DUODENOSCOPE ON THE PROGNOSIS OF THE PATIENTS WITH ACUTE GALLSTONE PANCREATITIS

作　　者：刘博[1] 王玉梅[2] 温桂海[1] 孔维[1] 尹清臣[1] 武来兴[1] 周少英[1] 

机构地区：[1]河北医科大学邯郸市中心医院普外一科,河北省邯郸市056001 [2]邯郸市第一医院中西医结合科

出　　处：《中国煤炭工业医学杂志》2013年第11期1888-1890,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的探讨中西医结合治疗对急性胆源性胰腺炎患者临床预后的影响。方法将60例急性胆源性胰腺炎患者,随机分为治疗组(中西医结合治疗组)与对照组(西医治疗组)各30例。二组患者经十二指肠镜治疗后,均予急性胰腺炎规范化治疗,包括监测生命体征、禁食水、胃肠减压、补充液体、维持水电解质和酸碱平衡、抗感染、镇痛、抑酸治疗、抑制胰酶活性等。治疗组经胃管注入中药复方大柴胡汤。比较二组患者治疗效果,观察二组患者腹痛腹胀缓解时间、首次排便时间、血尿淀粉酶恢复正常时间及第三天、第七天时APACHE-Ⅱ评分等。结果治疗组疗效优于对照组,差异有统计学意义(P<0.05)。治疗组腹痛腹胀缓解时间、首次排便时间、血尿淀粉酶恢复正常时间均短于对照组,差异均有统计学意义(P<0.05)。二组治疗3d、7d时APACHE-Ⅱ评分均下降,以治疗组下降更明显,差异有统计学意义(P<0.05)。结论十二指肠镜联合经胃管注入复方大柴胡汤治疗急性胆源性胰腺炎能够提高临床疗效,促进胃肠道功能恢复,缩短病程,值得推广应用。Objective To investigate the effect of methods the treatment of combined Chinese and Western medicine on the prognosis of the patients with acute gallstone pancreatitis. Methods Sixty patients with acute gallstone pancreatitis were randomly divided into treatment group and control group, each group had 30 cases. Two groups of patients after treatment with duodenoscope, participation in the standardized treatment of acute panereatitis, monitoring vital signs, fasting water, gastrointestinal decompression, venous transfusion, balance of water, electrolyte and acidbase, antiinfection, analgesia,acid suppression therapy, suppression of trypsin activity were included. In treatment group 30 cases received the Chinese medicine ＂Da Chai Hu Tang＂ injection by the stomach tube. Compare two groups of patients with therapeutic effect. Time for abdominal pain and abdominal distention relief, the first defecation time, and the time of blood and urine amylase returned to normal time were recorded. The acute physiology and chronic health evaluation Ⅱ score（ APACHE Ⅱ ） were calculated before and after 3 days, 7 days the treatment respectively. Results Treatment group curative effect was superior to control group（P〈0.05）. Compared with control group, remission time of abdominal pain and abdominal distention, first defecation time, blood and urine amylase returned to normal time of patients in treatment group shortened （P〈 0. 05）. Two groups after treatment the APACHE- Ⅱ score at day 3 and 7 decreased, in treatment group decreased more obvious, the differences were statistically significant （P〈0.05）. Conclusion The treatment of acute gallstone pancreatitis by method of duodenoscope combined with the Chinese medicine ＂Da Chai Hu Tang＂ injection by the stomach tube can improve the clinical efficacy and promote the recovery of gastrointestinal function. It is worthy of widely application.

关 键 词：十二指肠内镜 大柴胡汤 急性胆源性胰腺炎 中西医结合治疗 

分 类 号：R256.31[医药卫生—中医内科学]