通腑清胰汤治疗急性胰腺炎的临床疗效观察
发布时间：2019-01-16 05:30
【摘要】：目的本次临床实验将符合轻度急性胰腺炎标准,同时中医辨证为腹痛腑实热结证的患者作为研究对象,采用通腑清胰汤灌肠,客观地评价通腑清胰汤治疗急性胰腺炎的临床疗效及安全性,用以指导临床实践。方法1.病例来源选取2014年10月至2016年1月就诊于山西阳煤集团总医院消化内科的住院患者,收集符合本次研究标准病例60例,依据随机原则,将其纳入实验组和对照组各30例。两组给予同等西医综合治疗,对照组给予无菌水灌肠;实验组加用通腑清胰汤灌肠,两组用药时间及方法要求一致。分析记录两组患者治疗前后临床疗效评分,中医症状积分,肠功能积分情况,血清淀粉酶以及治疗前后1周CT分级改变,住院时间,比较两组疗效。2.本方组成:柴胡30g,黄芩20g,生白芍30g,太子参20g,半夏10g,枳实30g,厚朴30g,生大黄50g,玄明粉50g,栀子20g,黄连10g,佛手20g,吴茱萸10g,乌药20g,木香20g,玄参30g,生甘草3g。每副方药熬制浓缩400ml汤剂,每日早晚各1次,每次200ml,保留灌肠。结果临床综合疗效比较:两组总体有效率之间无明显差异(P㧐0.05),但实验组治愈显效率明显优于对照组(P0.05)。中医症候积分比较:两组治疗第5天症状较前均有明显改善(P㩳0.05),其中主症方面实验组与对照组之间具有明显差异(P㩳0.01);肠功能评分比较:两组治疗后肠功能均有显著改善(P㩳0.01),但实验组明显优于对照组(P㩳0.05)。治疗前后腹部CT比较:两组均有明显改善,但两组间无明显差异(P㧐0.05)。实验室指标:血淀粉酶恢复天数两组之间无明显差异。住院天数两组之间有统计学差异(P㩳0.05),且实验组住院时间更短。结论通腑清胰汤在缓解轻度急性胰腺炎早期(急性期)腑实热结证患者的腹痛腹胀等症状方面效果较为明显,说明通腑清胰汤治疗急性胰腺炎疗效确切。本研究开阔了急性胰腺炎治疗的新思路,为临床治疗急性胰腺炎提供理论依据,从而进一步改善并提高患者的生存质量,具有巨大的社会效益和经济效益。
[Abstract]:Objective to use Tongfu Qingyi decoction (Tongfu Qingyi decoction) to enema the patients who accord with the standard of mild acute pancreatitis and syndrome differentiation of traditional Chinese medicine (TCM) for abdominal pain and solid heat. Objective to evaluate the clinical efficacy and safety of Tongfu Qingyi decoction for guiding clinical practice. Method 1. From October 2014 to January 2016, 60 cases were collected from the Department of Digestive Medicine, Shanxi Yang Coal Group General Hospital. According to the random principle, they were included in the experimental group and the control group respectively. The two groups were given the same comprehensive western medicine treatment, the control group was given aseptic water enema, the experimental group was given Tongfu Qingyi decoction enema, the two groups used the same time and method. The clinical curative effect score, TCM symptom score, intestinal function score, serum amylase, CT grading and hospitalization time before and after treatment were recorded and compared between the two groups. 2. Composition: Bupleurum 30g, Scutellaria baicalensis 20g, Radix Paeoniae Alba 30g, Radix Pseudostellariae princeliae 20g, Pinellia ternata 10g, Fructus Aurantii 30g, Magnolia officinalis 30g, rhubarb 50g, Gardenia 20g, Coptis chinensis 10g, Buddha's hand 20g, Evodiae officinalis 10g, Radix Umbiae 20g, Muxiang 20g, Radix Xuanshen 30g. Licorice 3 g. Each prescription to make concentrated 400ml decoction, every morning and evening, 200 ml, retention enema. Results there was no significant difference in the total effective rate between the two groups (P0. 05), but the effective rate of the experimental group was significantly better than that of the control group (P0.05). Comparison of TCM symptom score: the symptoms of the two groups were significantly improved on the 5th day after treatment (P0. 05), and there was a significant difference between the experimental group and the control group in the main symptoms (P0. 01). Comparison of intestinal function score: after treatment, the intestinal function of the two groups were significantly improved (P0. 01), but the experimental group was significantly better than the control group (P0. 05). Comparison of abdominal CT before and after treatment: there was significant improvement in both groups, but there was no significant difference between the two groups (P0. 05). Laboratory index: there was no significant difference between the two groups in the days of blood amylase recovery. There was statistical difference between the two groups (P0. 05), and the time of hospitalization in the experimental group was shorter than that in the control group. Conclusion Tongfu Qingyi decoction is more effective in relieving abdominal pain and abdominal distention in patients with mild acute pancreatitis in early stage (acute phase), indicating that Tongfu Qingyi decoction is effective in treating acute pancreatitis. This study broadens the new thinking of treatment of acute pancreatitis, and provides theoretical basis for clinical treatment of acute pancreatitis, thus further improving and improving the quality of life of patients, with great social and economic benefits.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
[Abstract]:Objective to use Tongfu Qingyi decoction (Tongfu Qingyi decoction) to enema the patients who accord with the standard of mild acute pancreatitis and syndrome differentiation of traditional Chinese medicine (TCM) for abdominal pain and solid heat. Objective to evaluate the clinical efficacy and safety of Tongfu Qingyi decoction for guiding clinical practice. Method 1. From October 2014 to January 2016, 60 cases were collected from the Department of Digestive Medicine, Shanxi Yang Coal Group General Hospital. According to the random principle, they were included in the experimental group and the control group respectively. The two groups were given the same comprehensive western medicine treatment, the control group was given aseptic water enema, the experimental group was given Tongfu Qingyi decoction enema, the two groups used the same time and method. The clinical curative effect score, TCM symptom score, intestinal function score, serum amylase, CT grading and hospitalization time before and after treatment were recorded and compared between the two groups. 2. Composition: Bupleurum 30g, Scutellaria baicalensis 20g, Radix Paeoniae Alba 30g, Radix Pseudostellariae princeliae 20g, Pinellia ternata 10g, Fructus Aurantii 30g, Magnolia officinalis 30g, rhubarb 50g, Gardenia 20g, Coptis chinensis 10g, Buddha's hand 20g, Evodiae officinalis 10g, Radix Umbiae 20g, Muxiang 20g, Radix Xuanshen 30g. Licorice 3 g. Each prescription to make concentrated 400ml decoction, every morning and evening, 200 ml, retention enema. Results there was no significant difference in the total effective rate between the two groups (P0. 05), but the effective rate of the experimental group was significantly better than that of the control group (P0.05). Comparison of TCM symptom score: the symptoms of the two groups were significantly improved on the 5th day after treatment (P0. 05), and there was a significant difference between the experimental group and the control group in the main symptoms (P0. 01). Comparison of intestinal function score: after treatment, the intestinal function of the two groups were significantly improved (P0. 01), but the experimental group was significantly better than the control group (P0. 05). Comparison of abdominal CT before and after treatment: there was significant improvement in both groups, but there was no significant difference between the two groups (P0. 05). Laboratory index: there was no significant difference between the two groups in the days of blood amylase recovery. There was statistical difference between the two groups (P0. 05), and the time of hospitalization in the experimental group was shorter than that in the control group. Conclusion Tongfu Qingyi decoction is more effective in relieving abdominal pain and abdominal distention in patients with mild acute pancreatitis in early stage (acute phase), indicating that Tongfu Qingyi decoction is effective in treating acute pancreatitis. This study broadens the new thinking of treatment of acute pancreatitis, and provides theoretical basis for clinical treatment of acute pancreatitis, thus further improving and improving the quality of life of patients, with great social and economic benefits.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
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