加味黄连解毒汤灌肠治疗急性胰腺炎的疗效研究  

Effects of Modified Huanglian Jiedu Decoction Enema on Acute Pancreatitis

作　　者：汪海燕 黄秋萍 陈少如 张广清 Wang Haiyan;Huang Qiuping;Chen Shaoru;Zhang Guangqing(Hunan University of Chinese Medicin,Hunan,Changsha 410208,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]广州中医药大学第二附属医院,广东广州510006 [3]南方医科大学南方医院,广东广州510515

出　　处：《中国中医急症》2020年第12期2107-2110,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省中医药局资助项目(20170236)。

摘　　要：目的观察加味黄连解毒汤灌肠治疗急性胰腺炎的疗效。方法将106例急性胰腺炎患者分为对照组与观察组各53例。对照组给予西医常规治疗,观察组在西医常规治疗的基础上加用加味黄连解毒汤灌肠治疗,疗程为10 d。比较两组临床疗效的差异,治疗前后胰腺CT严重程度评估(CTSI)、急性胰腺炎严重程度估计指标(Ranson)、急性生理学与慢性健康状况评分(APACHEⅡ)、胃肠功能障碍评分、中医证候积分的变化,观察两组患者腹痛缓解、腹部压痛消失、肠鸣音恢复、肛门排气、肛门排便、血淀粉酶(AMY)、血脂肪酶(LPS)、尿淀粉酶(UAMY)、血常规(WBC)、超敏C反应蛋白(hs-CRP)等恢复正常的时间。结果观察组总有效率显著高于对照组(P<0.05);治疗后,两组患者的CTSI、Ranson、APACHEⅡ、胃肠功能障碍评分、中医证候评分均较治疗前降低(P<0.05),且观察组上述评分均低于对照组(P<0.05);观察组患者腹痛缓解、腹部压痛消失、肠鸣音恢复、肛门排气、肛门排便时间均短于对照组(P<0.05),AMY、LPS、UAMY、WBC、hs-CRP恢复正常时间均短于对照组(P<0.05)。结论加味黄连解毒汤灌肠治疗急性胰腺炎可以提高疗效,改善症状,促进恢复。Objective:To observe the curative effect of Modified Huanglian Jiedu Decoction enema on acute pancreatitis.Methods:A total of 106 patients with acute pancreatitis were divided into the control group and ob⁃servation group,53 cases in each group.The control group was given conventional treatment,and the observation group was given with conventional treatment combined with Modified Huanglian Jiedu Decoction enema.Both groups were treated for 10 days.The clinical efficacy of the two groups,pancreatic CT severity assessment(CTSI),acute pancreatitis severity evaluation index(Ranson),acute physiology and chronic health status score(APACHEⅡ),gastrointestinal dysfunction score,TCM syndrome changes before and after treatment of the two groups were compared;the relief of abdominal pain,disappearance of abdominal tenderness,recovery of bowel sounds,anal ex⁃haust,anal bowel movement,time of returning to normal of blood amylase(AMY),blood lipase(LPS),urine amylase(UAMY),white blood cell count(WBC),high-sensitivity C-reactive protein(hs-CRP)were observed.Results:After treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);the CTSI,Ranson,APACHEⅡ,gastrointestinal dysfunction scores,and TCM syndrome scores of the two groups decreased significantly(P<0.05),and the above scores in the observation group were lower than the control group(P<0.05);time of eased abdominal pain,disappeared abdominal tenderness,recovered bowel sounds,anal exhaust,anal bowel movements of the observation group were shorter than that of the control group(P<0.05),and the time for blood amylase,blood lipase,urine amylase,WBC,hs-CRP to return to normal was shorter than that of the control group(P<0.05).Conclusion:Modified Huanglian Jiedu Decoction enema for acute pancreatitis can improve the curative effect,improve symptoms and promote recovery.

关 键 词：急性胰腺炎 加味黄连解毒汤 灌肠 疗效 

分 类 号：R576[医药卫生—消化系统]