| 摘要: |
| 目的：观察中西医结合早期治疗急性重症胰腺炎（SAP）的效果。方法：将 138 例 SAP 患者随机分为 2 组，起病 48 h 内开始治疗，对照组 68 例采用常规治疗，治疗组 70 例以常规疗法联合中药内服、灌肠、外敷治疗，7 d 为 1 疗程。比较 2 组治疗前后血淀粉酶（AMY）、超敏 C- 反应蛋白（CRP）炎症指标的水平，症状与体征改善情况如腹泻开始时间、肠麻痹解除时间、体温正常时间、腹内压下降至预计值时间、APACHE Ⅱ评分降至预计值时间、临床疗效、ICU 中转及住院时间。结果：治疗后治疗组和对照组血清 AMY、CRP 水平均较治疗前降低，治疗组降幅更为显著（P < 0.05）。治疗组治疗后腹泻开始时间、肠麻痹解除时间、体温正常时间、腹内压下降时间、APACHE Ⅱ评分改善时间均较对照组明显缩短（P < 0.05）。治疗组住院日、ICU 中转率较对照组明显减少（P < 0.05）。治疗组总有效率较对照组明显提高，（P < 0.05）。结论：中西医结合治疗 SAP，较单纯西医治疗有显著的治疗效果。 |
| 关键词: 急性重症胰腺炎 中西医结合 早期 生化指标 |
| DOI：10.3969/j.issn.1007-6948.2019.04.009 |
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| 基金项目:浙江省医药卫生科研面上项目（2018KY652) |
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| Clinical Controlled Study on Curative Effect of Integrated Chinese and Western Medicine Early Therapy in Severe Acute Pancreatitis |
| LI Zhen,GAO Feng,YU Song-xia,ZHU Zheng-yuan |
| Emergency Department, the First People's Hospital of Xiaoshan, Hangzhou (311200), China |
| Abstract: |
| Objective To observe the effect of integrated Chinese and Western medicine therapy for severe acute pancreatitis (SAP) in early stage. Methods One hundred and thirty-eight patients with SAP were divided into two groups randomly. All of the patients started the therapy within 48h after getting SAP. The control group had 68 patients, who were treated with the routine method, while the 70 cases in observation group were given routine therapy integrated with Chinese medicine oral application, enema, and topical application. The treatment for both groups lasted for 7 d as one course. The measurement included the levels of amylase (AMY) and high sensitive C-reactive protein (CRP) before and after the treatment for both groups, symptoms and signs of patients in both groups before and after the treatment, including the starting point of diarrhea, time period of relieving enteroplegia (relief of abdominal distension, recovery of bowel sound and anal exhaustion), time period of returning to normal body temperature, time period of abdominal pressure returning to predicted values and time period of APACHE II rate returning to predicted values, clinical effects, ICU transfer and length of stay of both groups. Results After the treatment, the levels of serum AMY and CRP of both observation and control groups decreased signi?cantly (P < 0.05). The most signi?cant decrease was observed during the treatment in observation group (P < 0.05). Compared to the control group, the observation group had signi?cant decrease in the starting time of diarrhea, time period of relieving enteroplegia, time period of returning to normal body temperature, time period of the abdominal pressure returning to the predicted value, and time period of APACHE II rate returning to the predicted value (P < 0.05). Moreover, the length of stay and rate of ICU transfer of the observation group were also less than those of the control group, and the overall clinical efficiency of the observation group was higher than that of the control group (P < 0 . 05 ). Conclusion The curative effect of integrated Chinese and Western medicine therapy for SAP is signi?cant. It could ef?ciently improve the recovery of gastrointestinal function and the outcomes of patients. |
| Key words: Severe acute pancreatitis integrated Chinese and Western medicine therapy early stage biochemical indicator |
