芒硝外敷联合大黄承气汤治疗重症急性胰腺炎的临床疗效及其安全性  

Clinical efficacy and safety of external application of mirabilite combined with Dahuang Chengqi decoction in the treatment of severe acute pancreatitis

作　　者：陈国胜[1] 饶李亮 罗静 CHEN Guosheng;RAO Liliang;LUO Jing(Department of Critical Care Medicine,Huizhou Hospital of Traditional Chinese Medicine,Huizhou 516001,China)

机构地区：[1]广东省惠州市中医医院重症医学科,516001

出　　处：《临床合理用药杂志》2021年第18期30-32,35,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨芒硝外敷联合大黄承气汤治疗重症急性胰腺炎(SAP)的临床疗效及其安全性。方法选取惠州市中医医院2018年5月—2020年5月收治的SAP患者74例,随机分为对照组与观察组,各37例。对照组施行常规西医治疗,观察组施行常规西医+芒硝外敷+大黄承气汤治疗。比较2组临床疗效、血清淀粉酶恢复正常时间、治疗前后急性生理学及慢性健康状况评分系统(APACHEⅡ)评分、二胺氧化酶(DAO)、D-乳酸、白介素6(IL-6)、白介素8(IL-8)、肿瘤坏死因子α(TNF-α)、IgM、IgA、IgG,不良反应发生率。结果观察组总有效率高于对照组,血清淀粉酶恢复正常时间短于对照组(P<0.05)。治疗前2组APACHEⅡ评分比较,差异无统计学意义(P>0.05);治疗后观察组APACHEⅡ评分低于对照组(P<0.05)。治疗前2组DAO、D-乳酸比较,差异无统计学意义(P>0.05);治疗后观察组DAO、D-乳酸低于对照组(P<0.05)。治疗前2组IL-6、IL-8、TNF-α水平比较,差异无统计学意义(P>0.05);治疗后观察组IL-6、IL-8、TNF-α水平低于对照组(P<0.05)。治疗前2组IgM、IgA、IgG比较,差异无统计学意义(P>0.05);治疗后观察组IgM、IgA、IgG高于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论芒硝外敷联合大黄承气汤治疗SAP的临床疗效确切,可改善肠黏膜功能,减轻炎性反应,增强免疫功能,且安全性较高。Objective To investigate the clinical efficacy and safety of mirabilite external application combined with Dahuang Chengqi decoction in the treatment of severe acute pancreatitis(SAP).Methods A total of 74 cases of patients with SAP were selected from May 2018 to May 2020 in Huizhou Hospital of Traditional Chinese Medicine,which were randomly divided into control group and observation group,37 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with conventional western medicine+mirabilite external application+Dahuang Chengqi decoction.The clinical efficacy,serum amylase recovery time,APACHE Ⅱ score,diamine oxidase(DAO),D-lactate,interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),IgM,IgA,IgG and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group,and the normal time of serum amylase recovery was shorter than that of the control group(P<0.05).There was no significant difference in APACHE Ⅱ score between the two groups before treatment(P>0.05),and the score of APACHE Ⅱ in the observation group was lower than that of the control group(P<0.05).There was no significant difference between the two groups before treatment(P>0.05),and the DAO and D-lactate in the observation group were lower than that of the control group(P<0.05).There was no significant difference in the levels of IL-6,IL-8 and TNF-α between the two groups before treatment(P>0.05),and the levels of IL-6,IL-8 and TNF-α in the observation group were lower than those in the control group(P<0.05).There was no significant difference in IgM,IgA and IgG between the two groups before treatment(P>0.05),and the IgM,IgA and IgG in the observation group were higher than that in the control group(P<0.05).The incidence of adverse reactions in observation group was lower than that of control group(P<0.05).Conclusion Mirabilite external application comb

关 键 词：重症急性胰腺炎 芒硝外敷 大黄承气汤 治疗结果 

分 类 号：R576[医药卫生—消化系统]