如意止痛膏外敷联合西医治疗急性胰腺炎随机平行对照研究  

Ruyi Plaster External Random Parallel Control Study Combined Western Medicine Treatment of Acute Pancreatitis

作　　者：魏引廷[1,2] 顾勤[1] 

机构地区：[1]南京中医药大学,南京210000 [2]南京中医药大学连云港附属医院脾胃肝胆科,江苏连云港222004

出　　处：《实用中医内科杂志》2014年第4期113-116,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察如意止痛膏外敷联合西医治疗急性胰腺炎疗效。[方法]使用随机平行对照方法,将64例住院患者按抽签法随机分为两组。对照组32例基础治疗:①禁食、水,胃肠减压,改善胃肠功能紊乱导致的腹胀,缓解呕吐或肠梗阻等症状;②补液,纠正水、电解质紊乱,防止出现低血压及休克;③抑制胰腺分泌,使胰腺处于"休息状态"。奥曲肽,0.2mg/次,3次/d,静脉泵入;④镇静、止痛,布桂嗪(强痛定)100mg/次,肌注;必要时肌注哌替啶(杜冷丁)100mg/次;⑤营养支持,早期全肠外营养,肠功能恢复后,逐渐增加肠内营养,最终完全替代肠外营养;⑥对症处理,保护重要脏器功能。治疗组32例如意止痛膏,生大黄500g,川芎、元胡、厚朴、芒硝各100g,冰片、甘草各50g,饴糖适量;大黄、厚朴、川芎、玄胡、甘草磨粉过筛;饴糖加热熔化;细粉与芒硝混匀,加入熔化饴糖中,加40%二甲基矾搅拌,冷至40°,加入冰片混匀;分摊50纸上或布上,即得;将如意止痛膏外敷于胰腺体表投影区、脐部和局部炎性包块处,一日一换;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈24例,好转6例,无效2例,总有效率93.75%。对照组痊愈19例,好转9例,无效4例,总有效率87.50%。治疗组疗效优于对照组(P<0.05)。症状缓解治疗组优于对照组(P<0.05)。指标恢复时间治疗组优于对照组(P<0.05)。[结论]如意止痛膏外敷联合西医治疗急性胰腺炎效果显著,值得推广。[ Objective ] To observe the ruyi plaster external combined western medicine treatmentthe curative effect of acute pancreatitis. [ Methods ] Using random parallel control method, 64 cases of hospitalized patients were randomly divided into two groups according to the draw method. Control group 32 cases of foundation treatment： （ 1 ） fasting, water, gastrointestinal decompression, improve gastrointestinal dysfunction caused by abdominal distension, alleviate the symptom such as vomiting or intestinal obstruction. （ 2 ） the rehydration, correct water and electrolyte balance disorder, prevent hypotension and shock. （ 3 ） inhibition of pancreatic secretion, the pancreas in a state of ＂rest＂. Mr Qu peptide, 0.2 mg/time, 3 times/d, intravenous pumping. （ 4 ） sedative and analgesic, cassia oxazine （severe pain） 100 mg/times, intramuscular injection; When necessary muscle pethidine injection （demerol） 100 mg/time; （ 5 ） nutrition support treatment, early to adopt total parenteral nutrition, bowel function recovery after, gradually increase the enteral nutrition, eventually replace parenteral nutrition. 6. Take appropriate symptomatic treatment, protect important viscera function. Treatment group 32 such as piaster, Shengdahuang 500g, Chuanqiong, Yuan hu, Houpu, Mangxiao each lOOg, Bingpian, Gancao each 50g, Yitang right amount. Dahung, Houpu, Chuanqiong, Xuanhu, Gancao sift flour. Caramel heating melt again. Fine powder, and glauber＇s salt and mixed in melted caramel, plus 40% dimethyl alum stirring, cold to 40 ° , join the blending of borneol. Share 50 paper or cloth, quick. Will best plaster external treatment in pancreatic body surface projection area, time and local inflammatory bag piece, an in a day. Western medicine treatment with the control group. Continuous treatment of 7 d for 1 course of treatment. Observation of clinical symptoms and adverse reactions. As a course treatment, judge curative effect. Symptoms in treatment group is better than that of control group （ P〈O.

关 键 词：急性胰腺炎 外敷 如意止痛膏 奥曲肽 盐酸哌替啶 盐酸布桂嗪 随机平行对照研究 

分 类 号：R256.43[医药卫生—中医内科学] R244.9[医药卫生—中医学]