消胰散结方联合生长抑素+综合治疗急性胰腺炎(腑实热结)随机平行对照研究  

Randomized Parallel Controlled Study of Combined Therapy of Somatostatin and Xiaoyi Sanjie Recipe(消胰散结方) in Treating Acute Pancreatitis(Fushi Rejie/腑实热结)

作　　者：余二伟 夏雨 李爱敏 YU Erwei;XIA Yu;LI Aimin(Zhumadian Chinese Medicine Hospital Emergency Department,Zhumadian 463400,Henan,China)

机构地区：[1]驻马店市中医院急诊科,河南驻马店463000

出　　处：《实用中医内科杂志》2018年第9期34-37,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：河南省中医药科学研究专项课题(2016ZY2056)~~

摘　　要：[目的]观察消胰散结方联合生长抑素+综合治疗急性胰腺炎(腑实热结)疗效。[方法]使用随机平行对照方法,将100例住院诊患者按随机数字表方法随机分为两组,禁食、胃肠减压、抗炎、抑制胃酸分泌、止痛、抗痉挛、营养支持、纠正水电解质、酸碱平衡紊乱、低血压、低血容量和抗休克等。对照组50例生长抑素,首次缓慢静脉注射250μg,然后用微量泵持续静脉泵入250μg/h,根据临床表现连续静脉滴注5～7d。观察组50例消胰散结方(大黄~酒30g,芒硝^(冲服)15g,枳实、厚朴各12g,木香6g,黄芩12g,冬瓜子30g,半夏~清9g,丹皮15g,白芍12g),水煎服,150mL/次,1次/d;生长抑素治疗同对照组。连续治疗1周为1疗程。观测临床表现、血流量(BF)、毛细血管表面通透性(PS)、血容量(BV)、血清脂肪酶(LIP)、淀粉酶(AMY)、胰蛋白酶原-2(TPS-2)、正铜蓝蛋白(CP)、胰岛素(INS)、胰高血糖素(GLU)、白介素-10(IL-10)、肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、不良反应。连续治疗2疗程(2周),判定疗效。[结果]治疗组痊愈35例,好转13例,无效2例,总有效率96.00%;对照组痊愈31例,好转12例,无效7例,总有效率86.00%;临床疗效治疗组优于对照组(P<0.05)。血流量(BF)、毛细血管表面通透性(PS)、血容量(BV)、血清脂肪酶(LIP)、淀粉酶(AMY)、胰蛋白酶原-2(TPS-2)、正铜蓝蛋白(CP)、胰岛素(INS)、胰高血糖素(GLU)、白介素-10(IL-10)、肿瘤坏死因子(TNF-α)、白介素-6(IL-6)两组均有改善(P<0.05,P<0.01),治疗组改善优于对照组(P<0.01)。[结论]消胰散结方联合生长抑素+综合治疗急性胰腺炎(腑实热结),疗效满意,无严重不良反应,值得推广。[Objective] To observe the efficacy of Xiaoyi Sanjie recipe（消胰散结方） combined with somatostatin＋comprehensive treatment of acute pancreatitis. [Methods] Randomized parallel control method was used to randomly divide 100 inpatients into two groups according to the random number table method.Fasting, gastrointestinal decompression, anti-inflammatory, inhibition of gastric acid secretion, analgesia,antispasmodic, nutritional support, correction of water and electrolytes, acid Alkali balance disorder,hypotension, hypovolemia and anti-shock. In the control group, 50 cases of somatostatin, the first slow intravenous injection of 250μg, and then intravenously pumped 250 μg/h with a micro pump, according to clinical manifestations of continuous intravenous infusion of 5～7 d. Observation group 50 cases of Xiaoyi Sanjie（diabum wine 30 g, glauber＇s vinegar 15 g, medlar, magnolia 12 g, woody 6 g, astragalus 12 g, winter melon seeds 30 g, pinellia 9 g, Danpi 15 g, white peony 12 g）, boiled, 150 mL/time, once/d; somatostatin treatment with the control group. Continuous treatment for 1 week is a course of treatment. Observed clinical manifestations,blood flow（BF）, capillary surface permeability（PS）, blood volume（BV）, serum lipase（LIP）, amylase（AMY）,trypsinogen-2（TPS-2）, Bronzin（CP）, insulin（INS）, glucagon（GLU）, interleukin-10（IL-10）, tumor necrosis factor（TNF-α）, interleukin-6（IL-6）, adverse reactions. Continuous treatment for 2 courses（2 weeks）, to determine the efficacy. [Results] In the treatment group, 35 cases were cured, 13 cases were improved, 2 cases were ineffective, and the total effective rate was 96.00%. In the control group, 30 cases were cured,12 cases were improved, 7 cases were ineffective, and the total effective rate was 86.00%. The clinical efficacy treatment group was superior to the control group（P〈0.05）. Blood flow（BF）, capillary surface permeability（PS）, blood volume（BV）, serum lipase（LIP）, amylase（AMY）,

关 键 词：急性胰腺炎 腑实热结 腹痛 胃脘痛 结胸 消胰散结方 血流量(BF) 毛细血管表面通透性(PS) 血容量(BV) 血清脂肪酶(LIP) 淀粉酶(AMY) 胰蛋白酶原-2(TPS-2) 正铜蓝蛋白(CP) 胰岛素(INS) 胰高血糖素(GLU) 白介素-10(IL-10) 肿瘤坏死因子(TNF-α) 白介素-6(IL-6) 中西医结合治疗 中药复方 随机平行对照研究 

分 类 号：R576[医药卫生—消化系统]