疏肝清胰、通腑泄浊法治疗肝胆湿热型急性胰腺炎疗效观察  

Curative effect of therapy for dispersing liver and clearing pancreas, unblocking the fu-organs and discharging turbid on acute pancreatitis with syndrome of liver gallbladder heat and dampness

作　　者：严晓红 周雯 魏秀娟 王国民[1] 鄂辉 张晓静 YAN Xiaohong;ZHOU Wen;WEI Xiujuan;WANG Guomin;E Hui;ZHANG Xiaojing(Hebei Yiling Hospital,Shijiazhuang 050091,Hebei,China)

机构地区：[1]河北以岭医院

出　　处：《现代中西医结合杂志》2019年第25期2760-2764,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2019196)

摘　　要：目的探讨清胰通腑汤治疗肝胆湿热型急性胰腺炎的临床疗效。方法采用随机分组的方法将60例肝胆湿热型急性胰腺炎患者分为治疗组30例和对照组30例,2组给予相同西医治疗的同时,治疗组通过鼻胃管和灌肠的方式给予清胰通腑汤,对照组用同样的方式给予安慰剂。记录2组治疗第3天、治疗结束后全身炎症反应综合征缓解情况、血淀粉酶和CRP恢复情况,观察2组治疗前及治疗第3天、治疗结束后中医证候评分,统计2组中医证候疗效及胰腺CT疗效。结果治疗第3天及疗程结束后,治疗组的SIRS缓解率、淀粉酶恢复率及CRP恢复率均明显高于对照组(P均<0.05);治疗第3天治疗组的腹痛、口苦泛恶、小便短黄评分均明显低于对照组(P均<0.05);治疗第3天及疗程结束后,2组中医证候总分均明显低于治疗前(P均<0.05),且治疗组均明显低于对照组(P均<0.05)。治疗组的中医证候疗效和CT疗效均明显优于对照组(P均<0.05)。结论在西医治疗基础上早期应用清胰通腑汤治疗急性胰腺炎疗效更好,可加快胰腺局部炎症恢复,减轻胰腺局部组织破坏,加速疾病的恢复。Objective It is to investigate the clinical efficacy of therapy for dispersing liver and clearing pancreas,unblocking the fu-organs and discharging turbid on acute pancreatitis with syndrome of liver gallbladder heat and dampness.Methods Sixty patients with acute pancreatitis with syndrome of liver gallbladder heat and dampness were randomly divided into treatment group(n=30)and control group(n=30).Based on the same western medicine,the treatment group was given Qingyi Tongfu Decoction by nasogastric tube and enema,and the control group was given a placebo by the same administration.The remission of systemic inflammatory response syndrome(SIRS),the recovery of blood amylase and CRP on the third day of treatment and at the end of treatment were recorded in the two groups.The scores of TCM syndromes of the two groups before treatment and on the third day of treatment and after the treatment were observed.CT efficacy and TCM efficacy of the pancreas were assessed in the two groups.Results On the third day of treatment and at the end of the treatment,the SIRS remission rate,amylase recovery rate and CRP recovery rate of the treatment group were significantly higher than those of the control group(P<0.05).The scores of abdominal pain,bitterness taste,nausea,short and yellow urine in the treatment group were significantly lower than those in the control group on the third day of treatment(P<0.05).The total scores of TCM syndrome on the third day of treatment and after treatment were significantly lower than those before treatment in the two groups(P<0.05),and the scores were more significantly lower in the treatment group(P<0.05).The TCM syndrome efficacy and CT curative effect of the treatment group were both significantly better than that of the control group(P<0.05).Conclusion On the basis of western medicine treatment,the early application of Qingyi Tongfu Decoction is effective in treating acute pancreatitis,which can accelerate the recovery of local inflammation of the pancreas,reduce the local tissue destruction

关 键 词：急性胰腺炎 清胰通腑汤 安慰剂 全身炎症反应综合征 中医证候 

分 类 号：R576[医药卫生—消化系统]