柴芩承气汤早期内服与灌肠联合高强度综合疗法治疗重症急性胰腺炎临床研究  

Observation on the clinical efficacy of early oral administration and enema combined with high-intensity comprehensive therapy of Chaiqin Chengqi decoction in the treatment of severe acute pancreatitis

作　　者：郭迎雪 崔大鹏[1] 聂双发[1] 费建东[1] 李树铁[1] GUO Yingxue;CUI Dapeng;NIE Shuangfa;FEI Jiandong;LI Shutie(The First Affiliated Hospital of Hebei North University,Zhangjiakou 075061,China)

机构地区：[1]河北北方学院附属第一医院,河北张家口075061

出　　处：《陕西中医》2022年第8期1041-1044,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河北省卫生健康委员会医学科学研究课题(20211117)。

摘　　要：目的:探讨柴芩承气汤早期内服与灌肠联合高强度综合疗法治疗重症急性胰腺炎(SAP)的临床疗效。方法:选取84例SAP患者,采用随机数字表法分为对照组(给予西医高强度综合疗法治疗)和观察组(给予柴芩承气汤早期内服与灌肠+西医高强度综合疗法治疗),每组42例。比较两组患者治疗前后中医症候积分、急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分、相关症状改善时间、住院时间、血清学指标[血清淀粉酶(AMS)、白细胞(WBC)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)]、临床疗效及治疗后28 d并发症发生率。结果:观察组治疗后中医症候积分、APACHEⅡ评分均低于对照组(P<0.05)。观察组相关症状改善时间及住院时间均短于对照组(P<0.05)。观察组血清AMS、WBC、IL-6及TNF-α水平均低于对照组(P<0.05)。两组患者临床疗效比较差异具有统计学意义(P<0.05),且联合组总有效率高于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论:柴芩承气汤早期内服与灌肠联合高强度综合疗法治疗SAP可改善临床症状,抑制炎症反应,提高临床疗效,且可降低治疗后并发症发生率。Objective:To explore the clinical efficacy of early oral administration of Chaiqin Chengqi decoction combined with enema and high-intensity comprehensive therapy in the treatment of severe acute pancreatitis(SAP).Methods:A total of 84 SAP patients were selected and divided into a control group(given with western medicine high-intensity comprehensive therapy)and an observation group(Chaiqin Chengqi decoction was taken orally in the early stage)with enema+western medicine high-intensity comprehensive therapy,42 cases in each group.TCM symptom scores,acute physiology and chronic health scoreⅡ(APACHEⅡ)score,improvement time of related symptoms,hospitalization time,clinical efficacy,serological indexes[amylase(AMS),white blood cell(WBC),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]and complication rates were compared before and after treatment in the two groups of patients.Results:After treatment,the TCM symptom scores and APACHEⅡscores in observation group were lower(P<0.05).The improvement time of related symptoms in the observation group and the length of hospital stay were shorter(P<0.05).The serum levels of AMS,WBC,IL-6 and TNF-αin the observation group were lower(P<0.05).There was a significant difference in the distribution of clinical efficacy between the two groups(P<0.05),and the total effective rate in the combined group was higher(P<0.05).The incidence of complications in observation group was lower(P<0.05).Conclusion:Early oral administration of Chaiqin Chengqi decoction and enema combined with high-intensity comprehensive therapy to treat SAP can improve clinical symptoms,inhibit inflammation,improve clinical efficacy,and reduce the incidence of complications after treatment.

关 键 词：重症急性胰腺炎 柴芩承气汤 高强度综合疗法 血清淀粉酶 白细胞介素-6 

分 类 号：R657[医药卫生—外科学]