中药内注外敷疗法联合西医常规治疗急性胰腺炎湿热瘀滞证临床观察  

Clinical observation on the combination of traditional Chinese medicine internal injection and external application therapy with Western medicine routine treatment for damp heat and stasis syndrome in acute pancreatitis

作　　者：孙安 刘汉顺[1] 盛超[1] SUN An;LIU Hanshun;SHENG Chao(Department of Traditional Chinese Medicine,Hefei Third People's Hospital,Hefei Third Clinical College of Anhui Medical University,Hefei,230022,China)

机构地区：[1]合肥市第三人民医院中医科安徽医科大学合肥第三临床学院,合肥230022

出　　处：《中国中西医结合消化杂志》2024年第5期432-435,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：目的:观察中药内注外敷法联合西医常规治疗急性胰腺炎(AP)湿热瘀滞证的临床疗效。方法:选取来我院就诊的64例AP患者作为研究对象,使用随机数字表法,将患者分为治疗组和对照组,每组32例。其中对照组给予西医常规对症治疗,在此基础上,治疗组联合中药内注外敷法(胃管注入清胰通腑汤、加味大承气汤穴位贴敷),均治疗7 d。比较2组患者中医证候评分(腹痛、口苦、腹胀、排便)、急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,并评价中医证候疗效。分别于治疗前及治疗后第7天检测生化指标[血淀粉酶(AMS)、血清脂肪酶(LPS)、尿淀粉酶(UAMY)]以及炎症指标[C反应蛋白(CRP)]水平。结果:治疗组临床总有效率为93.75%,显著高于对照组的81.25%,差异有统计学意义(P<0.05)。治疗后,与治疗前及对照组比较,治疗组APACHEⅡ、腹痛、排便、腹胀、口苦评分均有改善,差异有统计学意义(P<0.05)。与治疗前及对照组比较,治疗组AMS、UAMY、LPS、CRP水平显著下降,差异有统计学意义(P<0.05)。结论:中药内注外敷法联合西医常规治疗AP湿热瘀滞证患者可抑制炎症反应,能有效改善患者胃肠道功能,缓解临床症状,值得借鉴。Objective To observe the clinical efficacy of traditional Chinese medicine internal injection and external application combined with conventional Western medicine in the treatment of damp heat stasis syndrome in acute pancreatitis(AP) and explore its possible mechanism.Methods Sixty-four AP patients who visited our hospital were selected as the research subjects. Using a random number table method, the patients were divided into two groups: the treatment group and the control group, with 32 cases in each group. The control group received routine symptomatic treatment with Western medicine for 7 days. The treatment group patients were treated with traditional Chinese medicine injection and external application(gastric tube injection of Qingyi Tongfu Formula and Jiawei Dachengqi Formula acupoint application) based on conventional Western medicine treatment for 7 days. Compare the scores of traditional Chinese medicine symptoms(abdominal pain, bitter mouth), physical signs(bloating, defecation), acute physiological function, and chronic health status evaluation system Ⅱ(APACHE Ⅱ) between two groups of patients, and evaluate the efficacy of traditional Chinese medicine syndromes. Biochemical indicators were measured before and on the 7th day of treatment, including blood amylase(AMS), urine amylase(UAMY), serum lipase(LPS), and inflammation indicator C-reactive protein(CRP) levels.Results The total clinical effective rate of the treatment group was 93.75%, significantly higher than that of the control group at 81.25%, with a statistically significant difference(P<0.05). After treatment, the APACHE Ⅱ, abdominal pain, defecation, bloating, and bitterness scores in the treatment group improved significantly compared to before treatment and the control group(P<0.05). Compared with before treatment and the control group, the levels of AMS, UAMY, LPS, and CRP in the treatment group significantly decreased, with statistical significance(P<0.05).Conclusion Combining traditional Chinese medicine internal injection and e

关 键 词：急性胰腺炎 清胰通腑汤 湿热瘀滞证 中药内注外敷疗法 加味承气汤 

分 类 号：R256.35[医药卫生—中医内科学]