大承气汤治疗急性胰腺炎患者胃肠功能障碍的临床观察  

Clinical observation of Dachengqi Decoction on gastrointestinal dysfunction in patients with acute pancreatitis

作　　者：李君秋 曹红燕 肖铁刚 周薏 傅志泉 LI Junqiu;CAO Hongyan;XIAO Tiegang;ZHOU Yi;FU Zhiquan(Second Department of Gastroenterology,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai,200032,China;department of Gastroenterology,Shanghai University of TCM,Shanghai Traditional Chinese Medicine-Integrated Hospital)

机构地区：[1]上海中医药大学附属龙华医院脾胃病二科,上海200032 [2]上海中医药大学附属上海市中西医结合医院脾胃病科

出　　处：《中国中西医结合消化杂志》2021年第10期686-690,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：上海市自然科学基金项目(No:16ZR1433800);上海市虹口区临床重点扶持专科项目(No:HKZK2020A01)。

摘　　要：目的:研究大承气汤对急性胰腺炎(AP)合并胃肠功能障碍(GID)的临床疗效。方法:将64例AP合并GID患者随机分为观察组(32例)和对照组(32例)。对照组予以常规西医治疗,观察组则为口服大承气汤+常规西医治疗,观察时间均为1周,比较2组患者禁食时间、住院时间、首次排气时间、肠鸣音恢复时间、首次排便时间、腹胀腹痛缓解时间、中医证候积分情况及不良反应。结果:治疗后,观察组禁食时间、住院时间均明显缩短于对照组(P<0.05);胃肠功能恢复方面,观察组在首次排气时间、肠鸣音恢复时间、首次排便时间、腹痛腹胀开始缓解的时间方面上,其时间值均明显缩短于对照组(P<0.01);中医证候积分方面,观察组在治疗3 d后和7 d后的中医证候积分明显小于对照组(P<0.05)。结论:大承气汤治疗AP合并GID患者,可以促进GID恢复,缩短患者的禁食时间、住院时间,有效改善患者中医证候,具有良好的安全性。Objective: To study the clinical effect of Dachengqi Decoction on acute pancreatitis complicated with gastrointestinal dysfunction. Methods: Sixty-four cases of acute pancreatitis with gastrointestinal dysfunction treated in Shanghai Traditional Chinese Medicine(TCM)-Integrated Hospital were randomly divided into Chinese Medicine observation group(32 cases) and Western medicine control group(32 cases). The Western medicine control group was given routine treatment, and the Chinese Medicine observation group was given routine treatment and Dachengqi Decoction. The observation time was 1 week. The fasting time, hospitalization time, first exhaust time, bowel sound recovery time, first defecation time, abdominal pain(abdominal distension) relief time, TCM syndrome scores and the effects of adverse reactions were compared between the two groups. Results: After treatment, fasting time and hospitalization time of observation group were significantly shortened compared with control group(P<0.05);In terms of the recovery of gastrointestinal function, the time values of the observation group in terms of the first exhaust time, the beginning of the recovery of intestinal sounds, the first defecation time, and the beginning of the relief of abdominal pain(abdominal distension) were significantly shorter than those of the control group(P<0.01);The scores of TCM symptoms in the observation group were significantly lower than those in the control group after 3 and 7 days of treatment(P<0.05). Conclusion: Dachengqi Decoction in the treatment of acute pancreatitis with gastrointestinal dysfunction can promote the recovery of gastrointestinal dysfunction, shorten the fasting time and hospitalization time of patients, effectively improve the symptoms of Traditional Chinese Medicine in patients, and has good safety.

关 键 词：大承气汤 急性胰腺炎 腑实热结证 胃肠功能 

分 类 号：R576[医药卫生—消化系统]