生大黄灌肠辅助治疗急性胰腺炎的临床疗效及对淀粉酶与炎性炎症因子的影响

发布时间：2018-02-20 20:40

本文关键词： 生大黄灌肠急性胰腺炎淀粉酶炎症因子　出处：《辽宁中医杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的:探讨生大黄灌肠辅助治疗急性胰腺炎的临床疗效及对淀粉酶与炎性炎症因子的影响。方法:选择2014年4月—2016年4月本院接诊的150例急性胰腺炎患者作为本次研究对象,通过随机数表法分为观察组和对照组,各75例。对照组给予常规治疗,观察组在对照组基础上加上生大黄灌肠辅助治疗。比较两组患者临床症状恢复时间,实验室指标、肿瘤坏死因子(TNF-α)、白细胞介素(IL-6)、C反应蛋白(hs-CRP)的变化,并评价临床疗效。结果:治疗后,观察组在腹痛、腹胀,排便,腹部压痛,肠鸣音恢复时间上均比对照组短[(3.45±0.84)d vs(4.87±1.21)d,(2.56±0.45)d vs(4.23±1.13)d,(4.52±0.93)d vs(5.34±1.24)d,(2.34±0.42)d vs(3.84±0.78)d],住院时间短于对照组[(10.23±2.31)d vs(15.18±2.74)d](P0.05);两组患者在第3天开始,腹腔内压水平得到明显下降,观察组在3d、4 d、5 d、6 d时,腹腔内压水平均比对照组低[(13.41±2.85)vs(14.59±3.15),(7.65±1.23)vs(12.93±1.54),(7.28±1.35)vs(10.39±1.20),(6.42±1.15)vs(8.03±1.06)](P0.05);观察组血清淀粉酶、血尿素氮、血细胞水平均低于对照组,血钙水平高于对照组[(205.89±42.30)U/L vs(294.74±70.41)U/L,(11.34±1.23)mmol/L vs(15.84±1.78)mmol/L,(11.34±1.68)×10~9L~(-1)vs(14.58±1.82)×10~9L~(-1),(2.19±0.12)mmol/L vs(1.84±0.15)mmol/L](P0.05);在炎症因子中,观察组TNF-α、IL-6、hs-CRP水平均比对照组低[(41.23±7.53)ng/L vs(58.12±10.65)ng/L,(23.12±4.57)μg/L vs(38.45±8.35)μg/L,(32.12±8.51)mg/L vs(39.84±9.42)mg/L](P0.05);观察组治疗后总有效率明显比对照组高[93.33%(70/75)vs77.33%(58/75)](P0.05)。结论:在急性胰腺炎患者中给予生大黄灌肠辅助治疗效果显著,可有效改善患者体内淀粉酶及炎症因子的表达,缓解病情,值得应用推广。
[Abstract]:Objective: to investigate the clinical effect of rhubarb enema on acute pancreatitis and its effect on amylase and inflammatory cytokines. Methods: 150 patients with acute pancreatitis were selected from April 2014 to April 2016. The observation group was divided into observation group and control group with 75 cases each. The control group was given routine treatment, the observation group was treated with rhubarb enema on the basis of the control group, and the clinical symptom recovery time and laboratory index were compared between the two groups. Changes of TNF- 伪, IL-6, IL-6, C-reactive protein hs-CRP, and evaluation of clinical efficacy. Results: after treatment, the observation group was treated with abdominal pain, abdominal distension, defecation, abdominal tenderness, abdominal tenderness, abdominal distension, abdominal tenderness. The recovery time of bowel sounds was shorter than that of the control group [3.45 卤0.84d vs(4.87 卤1.21d vs(4.87 卤0.45d vs(4.23 卤1.13d vs(5.34 4.52 卤1.24d vs(5.34 卤0.78d], and the hospitalization time was shorter than that of the control group [10.23 卤2.31d vs(15.18 卤2.74d] P0.050.The patients in both groups had a significant decrease in intraperitoneal pressure on the 3rd day, and the patients in the observation group had a significant decrease in the level of intraperitoneal pressure on the 3rd day after 4 days, 5 days after 6 days, and the duration of hospitalization was less than that in the control group [10.23 卤2.31 days, vs(15.18 卤2.74 days], and the levels of intraperitoneal pressure in the two groups were significantly lower than those in the control group on the 3rd day, 4 days, 5 days, 6 days after treatment, and the duration of hospitalization was less than that of the control group. The level of intraperitoneal pressure was lower than that of the control group (13.41 卤2.85 vs 14.59 卤3.15v / L 7.65 卤1.23V / L 12.93 卤1.545.28 卤1.35v / s = 10.39 卤1.20v / s 8.03 卤1.06respectively); the levels of serum amylase and blood urea nitrogen in the observation group were all lower than those in the control group, and the serum calcium level was higher than that in the control group [205.89 卤42.30U / L vs(294.74 卤70.41U / L vs(294.74 卤70.41U / mol / L = 11.34 卤1.23mmol / L vs(15.84 卤1.78mmol / L] 109L- 1s14.58 卤1.81010L-1 / L + 0.151mmol 卤0.151mmol 卤0.151mmol / L; The levels of IL-6hs-CRP in the observation group were lower than those in the control group [41.23 卤7.53ng / L vs(58.12 卤10.65ng / L vs(58.12 卤10.65ng / L] 渭 g / L vs(38.45 卤8.35 渭 g / L vs(38.45 卤8.35 渭 g / L respectively. Conclusion: the effect of adjuvant treatment with rhubarb was significant in patients with acute pancreatitis, and the total effective rate in the observation group was significantly higher than that in the control group [93.337075v / s 77.3358 / 75]. Can effectively improve the expression of amylase and inflammatory factors in patients, ease the disease, worthy of application and promotion.
【作者单位】：儋州市人民医院消化内科;
【分类号】：R576

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