经鼻空肠管注入生大黄治疗急性胰腺炎  

Clinical analysis of intranasal jejunal injection of raw rhubarb in treating acute pancreatitis

作　　者：梁杏仪 郭广彬 周定耕[3] 

机构地区：[1]广州市番禺区市桥街北片社区卫生中心中医科,广东番禺511400 [2]广州市番禺中心医院内科,广东番禺511400 [3]南华大学附属第二医院急诊科,湖南衡阳421001

出　　处：《长春中医药大学学报》2015年第2期367-369,共3页Journal of Changchun University of Chinese Medicine

基　　金：衡阳市科技计划项目(2013KJ322)

摘　　要：目的观察经鼻空肠管注入生大黄治疗急性胰腺炎的临床疗效。方法将急性胰腺炎患者50例随机分为治疗组和对照组,各25例,所有患者入院后均给予吸氧、重症监护、禁食禁水、胃肠减压等常规治疗,治疗组给予经鼻空肠管注入生大黄治疗,对照组给予胃管注入生大黄治疗,对比2组治疗前、后APACHE-Ⅱ评分、Balthazar CT积分、细胞因子水平、血淀粉酶恢复正常时间等指标。结果治疗组CRP、血清淀粉酶恢复时间以及肛门排气排便时间明显早于对照组(P<0.05);治疗7 d后治疗组APACHE-Ⅱ评分明显低于对照组(P<0.05),但组间Balthazar CT评分差异无统计学意义;治疗组治疗后血清IL-1、IL-6及内毒素水平均低于对照组(P<0.05);治疗组并发症发生率显著低于对照组(P<0.05)。结论经鼻空肠管注入生大黄治疗急性胰腺炎,能使药物有效成分直接作用于肠道黏膜,有利于药物吸收,促进肠功能恢复。Objective To observe the clinical efficacy of intranasal jejunal injection of raw rhubarb in treating acute pancreatitis. Methods A total of 50 patients with acute pancreatitis were randomized divided into the observation group and the control group with 25 cases in each group. All the patients were given oxygen inhalation,intensive care,fasting for solids and liquids,and gastrointestinal decompression on admission,Then,the patients in the observation group were given intranasal jejunal injection of raw rhubarb; while the patients in the control group were injected with raw rhubarb via stomach tube. The APACHE-II score,Balthazar CT integral,cytokine level,and the time for serum amylase to return normal in the two groups before and after treatment were compared. Results The CRP,the time for serum amylase to return normal,and the postoperative flatus,bowel movement time in the observation group were significantly earlier than those in the control group（ P〈 0. 05）. The APACHE-II score in the observation group after 7-day treatment was significantly lower than that in the control group（ P〈 0. 05）; however,the comparison of Balthazar CT integral between the two groups was not statistically different. The serum IL-1,IL-6,and endotoxin levels in the observation group after treatment were significantly lower than those in the control group（ P〈 0. 05）. The occurrence rate of complications in the observation group was significantly lower than that in the control group（ P〈 0. 05）. Conclusion It can be concluded that intranasal jejunal injection of raw rhubarb in treating acute pancreatitis can make the effective compositions of herbs directly act on intestinal mucous membrane which is in favor of drug absorption,and promote the recovery of intestinal function with an accurate efficacy.

关 键 词：急性胰腺炎 大黄 经鼻空肠管注入 

分 类 号：R289.5[医药卫生—方剂学]