乌司他丁联合生大黄治疗ERCP术后胰腺炎的效果观察  

Effect Observation of Ulinastatin Combined with Unprocessed Dahuang in the Treatment of Post-ERCP Pancreatitis

作　　者：卢志勇 黄超 钟谷平 王河 张善金 谢萍 LU Zhiyong;HUANG Chao;ZHONG Guping;WANG He;ZHANG Shanjin;XIE Ping(Yichun People's Hospital,Jiangxi Province,Yichun 336000,China;不详)

机构地区：[1]江西省宜春市人民医院,江西宜春336000

出　　处：《中国医学创新》2023年第29期42-46,共5页Medical Innovation of China

基　　金：江西省中医药管理局科技计划项目(2022B643);宜春市指导性科技计划项目(2022ZDJH6102)。

摘　　要：目的:探讨乌司他丁联合生大黄治疗内镜逆行胰胆管造影术(ERCP)术后胰腺炎(PEP)的临床效果。方法:选取2020年4月—2022年12月至宜春市人民医院行ERCP术后出现PEP的60例患者作为研究对象,使用信封法将其随机分为试验组和对照组,各30例。两组均予以禁食、抗感染、抑酸抑酶、胃肠减压、营养支持及镇痛镇静等对症治疗,对照组在常规治疗的基础上,另予乌司他丁治疗,试验组在对照组基础上,另予生大黄治疗。比较两组患者临床转归情况、血清淀粉酶和炎症因子水平、临床疗效及并发症发生率。结果:试验组腹痛腹胀消失时间、肠鸣音复常时间、首次排气时间均短于对照组(P<0.05);治疗后,试验组血清淀粉酶、C反应蛋白(CRP)、白细胞计数(WBC)、白细胞介素-6(IL-6)水平均低于对照组(P<0.05);试验组临床疗效显著优于对照组(P<0.05);试验组休克发生率明显低于对照组(P<0.05),但两组胰性脑病、急性肾功能不全(ARI)、多器官功能障碍综合征(MODS)发生率比较,差异均无统计学意义(P>0.05)。结论:乌司他丁联合生大黄治疗PEP的效果显著,可明显降低炎症因子水平,改善胃肠功能,降低休克发生率。Objective:To investigate the clinical effect of Ulinastatin combined with unprocessed Dahuang in the treatment of post-endoscopic-retrograde-cholangio-pancreatography(ERCP)pancreatitis(PEP).Method:A total of 60 patients who developed PEP after received ERCP in Yichun People's Hospital from April 2020 to December 2022 were selected as research objects,and were randomly divided into experimental group and control group according to envelope method,with 30 cases in each group.Both groups were treated with fasting,anti-infection,acid and enzyme inhibition,gastrointestinal decompression,nutritional support and analgesia and sedation.The control group was treated with Ulinastatin on the basis of conventional treatment,and the experimental group was treated with unprocessed Dahuang on the basis of control group.The clinical outcomes situation,the levels of serum amylase and inflammatory factors,clinical efficacy and incidence of complications were compared between the two groups.Result:The disappearance time of abdominal pain and abdominal distension,the return time of bowel sound and the first time of exhaust in experimental group were shorter than those in control group(P<0.05).After treatment,the levels of serum amylase,C reactive protein(CRP),white blood cell count(WBC)and interleukin-6(IL-6)in experimental group were lower than those in control group(P<0.05).The clinical effect of experimental group was significantly better than that of control group(P<0.05).The incidence of shock in experimental group was significantly lower than that in control group(P<0.05),but there were no significant differences in the incidence of pancreatic ncephalopathy,acute renal insufficiency(ARI)and multiple organ dysfunction syndrome(MODS)between the two groups(P>0.05).Conclusion:Ulinastatin combined with unprocessed Dahuang has a significant effect on PEP,which can significantly reduce the levels of inflammatory factors,improve gastrointestinal function,and reduce the incidence of shock.

关 键 词：乌司他丁 生大黄 内镜逆行胰胆管造影术 术后胰腺炎 

分 类 号：R259[医药卫生—中西医结合]