培菲康联合柴芍承气汤对早期肠内营养支持重症急性胰腺炎疗效的影响  

Effect of Bifico combined with Chaishao Chengqi Decoction in the treatment of severe acute pancreatitis with early enteral nutrition support

作　　者：康凯[1] 孙善明[2] 陈效华[2] 曲红梅[2] 田强[2] 宗蕾[2] 朱玲[2] 

机构地区：[1] 潍坊医学院,山东潍坊261053 [2] 山东省潍坊市人民医院

出　　处：《临床内科杂志》2015年第1期39-41,共3页Journal of Clinical Internal Medicine

基　　金：潍坊市卫生局中医药科研项目计划（2014年第3类007号）

摘　　要：目的 评价培菲康联合柴芍承气汤对早期肠内营养支持治疗重症急性胰腺炎（SAP）疗效的影响.方法 将47例SAP患者随机分为早期肠内营养支持（EEN）＋传统治疗组（PN组,15例）,PN组＋柴芍承气汤组（中药组,17例）,中药组＋培菲康组（观察组,15例）.测定3组患者治疗前和治疗后第1天、5天、9天和14天血清中内毒素、C反应蛋白（CRP）、肿瘤坏死因子（TNF）-α浓度,比较住院时间、住院总费用及并发症、病死率.结果 与治疗前比较,患者经治疗后第5天起血清CRP、内毒素、TNF-α均改善.治疗后第1天3组患者间血清指标比较差异无统计学意义（P＞0.05）;与PN组比较,中药组和观察组第5天和第9天血清指标降低显著（P＜0.05）;与中药组比较,观察组从第9天开始对指标改善作用更显著（P＜0.05）.与中药组、PN组比较,观察组患者住院时间缩短,并发症发生率和病死率降低,差异有统计学意义（P＜0.05）,观察组和中药组患者住院费用较PN组均减少（P＜0.05）.治愈出院42例.结论 培菲康联合柴芍承气汤在早期肠内营养支持SAP治疗中血清指标改善显著,减少并发症,降低死亡率,减少住院时间.Objective To evaluate the effect of Bifico combined with Chaishao Chengqi Decoc- tion in the treatment of severe acute pancreatitis（SAP） with early enteral nutrition support. Methods Forty-seven SAP patients were recruited and randomly divided into early enteral nutrition support （early enteral nutrition, EEN） ＋ conventional therapy group（ 15 cases, PN group）, PN ＋ Chaishao chengqi De- coction group （17 cases, Chinese medicine group）, and Chinese medicine group ＋ Bifico group（ 15 cases, observation group）. Serum concentration of endotoxin, C reactive protein （ CRP）, tumor necrosis factor （TNF）-c~ were detected at 0 d, 1 d,5 d,9 d, 14 d of the treatment. The total cost and duration of hospitali- zation, the incidence of complications and mortality were analysed. Results There were no differences in serum concentrations of CRP, endotoxin, TNF-c~ among 3 groups before treatment （ P 〉 0.05 ）. Compared with parameters before treatment, CRP, endotoxin, TNF-o~ improved from day 5th. Compared with PN group,concentrations of CRP, endotoxin, TNF-ct in traditional Chinese medicine group and observation group decreased significantly from day 5th and 9th （ P 〈 0.05 ）. Compared with the traditional Chinese medicine group, concentrations of those mentioned above in the observation group decreased significantly from day 9th（ P 〈 0.05 ）. Compared with the traditional Chinese medicine group and PN group, hospitali- zation time in the observation group shortened, complication incidence and mortality rate reduced （P 〈 0.05）. Compared with the PN group, hospitalization expenses reduced in the observation group and the traditional Chinese medicine group （ P 〈 0.05 ）. Finally 40 patients were cured and discharged. Conclu- sion Bifico combined with Chaishao Chengqi Decoction and EEN showed better effect on serum indexes in the treatment of SAP. reduced comolications, mortality rate and hosoitalization time.

关 键 词：培菲康 重症急性胰腺炎 早期肠内营养 柴芍承气汤 

分 类 号：R657.51[医药卫生—外科学]