大黄清解汤早期辅助治疗重症胰腺炎疗效观察  

Effect of Dahuang Qingjie Decoction on Patients with Severe Acute Pancreatitis

作　　者：熊静芳[1] 聂晶[1] 张兆林[1] 石占利[1] 孙文丽[1] 庞玉萍[1] 李娟[1] 

机构地区：[1]杭州市红十字会医院,浙江杭州310003

出　　处：《中华中医药学刊》2016年第4期924-926,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省自然科学基金项目(LY13H290008)

摘　　要：目的:探讨早期使用大黄清解汤辅助治疗重症胰腺炎的临床疗效。方法:将35例重症胰腺炎患者随机分成两组:对照组予重症监护、氧疗、禁食、胃肠减压、液体复苏、营养支持、抑酸护胃、抑制胰酶分泌以及抗感染等西医内科保守治疗;治疗组在西医内科保守治疗的基础上,入院12 h内加用大黄清解汤灌胃,观察两组患者入院后的腹痛腹胀缓解时间、肛门排便排气时间、SIRS或MODS发生率以及死亡率,血淀粉酶、白细胞及CRP水平,评估APACHE II以及Balthazar CT评分。结果:治疗组患者的临床症状缓解时间、肛门排便排气时间显著低于对照组;治疗组有效率显著高于对照组,两组的死亡率比较无明显差异,但对照组的SIRS/MODS发生率显著高于治疗组。治疗7 d,治疗组患者的白细胞计数和血淀粉酶水平与对照组比较,显著下降。治疗14 d,治疗组患者的APACHE II显著低于对照组。结论:大黄清解汤能有效缓解重症胰腺炎患者的胃肠道症状,改善APACHE II评分,降低白细胞和淀粉酶,降低SIRS/MODS发生率,改善预后。Objective： To evaluate the effect of Dahuang Qingjie Decoction on patients with severe acute pancreatitis（ SAP）.Methods： Thirty-five SAP patients were randomly divided into two groups with 17 cases in the control group and18 cases in the treatment group.Patients in the control group received intensive care,oxygen therapy,fasting,gastrointestinal decompression,fluid resuscitation,nutritional support,acid suppression protecting stomach,inhibition of pancreatic secretion and antibiotics.Patients in the treatment group received Dahuang Qingjie Decoction by gavage in addition.The relief time of intestinal symptoms,anal defecation exhausting time,incidence of SIRS / MODS,mortality,blood amylase,WBC and CRP levels,APACHE II and Balthazar CT rating were evaluated.Results： The relief time of intestinal symptoms and anal defecation exhausting time in the treatment group were significantly decreased compared to those of the control group.There was no significant difference in mortality between two groups.The incidence of SIRS / MODS in the control group was significantly increased compared to that of the treatment group.After treatment for 7 days,the blood amylase and WBC levels in the treatment group were significantly decreased compared to those of the control group.After treatment for 14 days,the APACHE II rating in the treatment group was significantly decreased compared to that of the control group.Conclusions： Dahuang Qingjie Decoction effectively improves the disturbing gastrointestinal symptoms and APACHE II rating and decreases blood amylase and WBC levels and reduces the incidences of SIRS and MODS in SAP patients.

关 键 词：重症胰腺炎 大黄清解汤 辅助治疗 

分 类 号：R576[医药卫生—消化系统]