早期肠内营养联合柴芩承气汤治疗重症急性胰腺炎的临床观察  

Clinical Observation on Early Enteral Nutrition Combined with Chaiqin Chengqi Decoction in the Treatment of Severe Acute Pancreatitis

作　　者：朱林[1] 陈亚忠 

机构地区：[1]四川大学华西医院中西结合科,成都610041 [2]成都市天府新区人民医院中医科,成都610213

出　　处：《世界中医药》2017年第12期3020-3022,3026,共4页World Chinese Medicine

摘　　要：目的:评价早期肠内营养联合柴芩承气汤灌胃治疗重症急性胰腺炎患者的疗效与安全性。方法:选取2013年1月至2014年1月在四川大学华西医院中西医结合科收治的重症急性胰腺炎患者64例,随机分为观察组和对照组,每组32例。2组患者均接受标准的西医治疗方案,其中观察组在西医方案基础上给予肠内营养联合柴芩承气汤,对照组给予肠外营养。观察指标包括:血清淀粉酶,血清CRP、TNF-α,中医症候评分,改良Marshall评分,CT评分,并发症发生情况,住院时间,治疗费用。结果:2组基线情况相比无统计学意义(P>0.05),具有可比性,全部64例患者均按方案完成了试验。观察组治疗后血清淀粉酶和血清CRP、TNF-α,中医症候评分,改良Marshall评分,CT评分,较对照组改善更显著(P<0.05);观察组多器官功能障碍、胰周脓肿的并发症发生率较对照组更低(P<0.05),而假性囊肿发生率2组相当(P>0.05);观察组住院时间较对照组更短(P<0.05),治疗费用较对照组更低(P<0.05)。2组均未观察到药物相关的不良反应。结论:采用早期肠内营养联合柴芩承气汤治疗SAP,临床疗效显著,安全性良好,住院时间短,治疗费用低,值得临床推广及应用。Objective： To evaluate the efficacy and safety of early enteral nutrition combined with Chaiqin Chengqi decoction in the treatment of severe acute pancreatitis. Methods： From January 2013 to January 2014,a total of 64 patients with severe acute pancreatitis in the department of integrated TCM western medicine,West China Hospital of Sichuan University were randomly divided into observation group and control group,with 32 cases in each group. All patients in two groups were received standard western medicine treatment. Among them,the observation group was given enteral nutrition combined with Chaiqin Chengqi decoction,and the control group was given parenteral nutrition. The observation indexes included the serum amylase,the serum CRP,TNF-α,the TCM symptom score,the modified Marshall score,the CT score,the incidence of the complication,the hospitalization time and the treatment costs. Results： There was no significant difference in baseline between the two groups（ P〈0. 05）,which was comparable. All of the 64 patients had completed the trial according to the protocol. After treatment,the serum amylase and the serum CRP,TNF-alpha,the TCM symptom score,the modified Marshall score,the CT score in the observation group were significantly better than those in the control group（ P〈0. 05）. The complication rate of multiple organ dysfunction and peripancreatic abscess in the observation group was lower than that in the control group（ P〈0. 05）,while the incidence of pseudocyst was the same in the two groups（ P〈0. 05）. The hospitalization time of the observation group was shorter than that of the control group（ P〈0. 05）,and the treatment cost was lower than that of the control group（ P〈0. 05）. No drug-related adverse reactions were observed in the two groups. Conclusion： There is a good clinical curative effect and safety,short hospitalization time,and low treatment cost in the treatment of SAP by the use of early enteral nutrition combined with Chaiqin Chengqi Decoction,which is w

关 键 词：重症急性胰腺炎 柴芩承气汤 随机对照试验 

分 类 号：R242[医药卫生—中医临床基础]