大黄清解汤早期辅助治疗重症胰腺炎疗效观察

发布时间：2018-08-28 13:49

【摘要】：目的:探讨早期使用大黄清解汤辅助治疗重症胰腺炎的临床疗效。方法:将35例重症胰腺炎患者随机分成两组:对照组予重症监护、氧疗、禁食、胃肠减压、液体复苏、营养支持、抑酸护胃、抑制胰酶分泌以及抗感染等西医内科保守治疗;治疗组在西医内科保守治疗的基础上,入院12 h内加用大黄清解汤灌胃,观察两组患者入院后的腹痛腹胀缓解时间、肛门排便排气时间、SIRS或MODS发生率以及死亡率,血淀粉酶、白细胞及CRP水平,评估APACHE II以及Balthazar CT评分。结果:治疗组患者的临床症状缓解时间、肛门排便排气时间显著低于对照组;治疗组有效率显著高于对照组,两组的死亡率比较无明显差异,但对照组的SIRS/MODS发生率显著高于治疗组。治疗7 d,治疗组患者的白细胞计数和血淀粉酶水平与对照组比较,显著下降。治疗14 d,治疗组患者的APACHE II显著低于对照组。结论:大黄清解汤能有效缓解重症胰腺炎患者的胃肠道症状,改善APACHE II评分,降低白细胞和淀粉酶,降低SIRS/MODS发生率,改善预后。
[Abstract]:Objective: to investigate the clinical effect of early use of Dahuang Qingjie decoction in the treatment of severe pancreatitis. Methods: 35 patients with severe pancreatitis were randomly divided into two groups: the control group was treated with intensive care, oxygen therapy, fasting, gastrointestinal decompression, fluid resuscitation, nutritional support, acid and stomach protection, inhibition of trypsin secretion and anti-infection. The treatment group was treated with rhubarb Qingjie decoction for 12 hours on the basis of conservative treatment in western medicine. The time of abdominal distension relief, anal defecation and exhaust time and mortality rate, serum amylase were observed in both groups. WBC and CRP levels, APACHE II and Balthazar CT scores were evaluated. Results: the clinical symptom relief time and anal defecation exhaust time in the treatment group were significantly lower than those in the control group, the effective rate in the treatment group was significantly higher than that in the control group, and there was no significant difference in the mortality between the two groups. But the incidence of SIRS/MODS in the control group was significantly higher than that in the treatment group. The white blood cell count and serum amylase level in the treatment group were significantly lower than those in the control group 7 days after treatment. The APACHE II of the patients in the treatment group was significantly lower than that in the control group at 14 days. Conclusion: rhubarb Qingjie decoction can effectively relieve gastrointestinal symptoms, improve APACHE II score, reduce white blood cell and amylase, reduce incidence of SIRS/MODS and improve prognosis in patients with severe pancreatitis.
【作者单位】： 杭州市红十字会医院;
【基金】：浙江省自然科学基金项目(LY13H290008)
【分类号】：R576

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