早期益活清下法治疗高脂血症性重症急性胰腺炎的临床研究.DOCVIP

临床医学论文-早期益活清下法治疗高脂血症性重症急性胰腺炎的临床研究 ????????????????? 作者：薛平, 邓力晖, 张肇达, 夏庆, 黄宗文, 杨晓楠, 蒋俊明 【摘要】? 　　目的：探讨早期采用益活清下法治疗高脂血症性重症急性胰腺炎（severe acute pancreatitis, SAP）的疗效。方法：依据纳入和排除标准，选取高脂血症性SAP 104例，按入院接受治疗的时间分成早期组52例（发病3 d内入院）和晚期组52例（发病后3～7 d入院），所有病例入院后均接受益活清下法治疗。结果：两组入院时Ranson评分、CT评分、急性生理和慢性健康评价指标Ⅱ评分的差异均无统计学意义（P0.05）。发病第10天，早期组血清甘油三酯低于晚期组（P0.01）；早期组急性呼吸窘迫综合征、肾功能衰竭、肝功能不全、心功能衰竭、脑病、休克、感染及消化道出血的发生率低于晚期组（P0.05）；早期组病死率低于晚期组（P0.05）；住院时间也短于晚期组（P0.05）。结论：早期采用益活清下法治疗高脂血症性SAP可以取得更好疗效。 【关键词】? 高脂血症; 胰腺炎; 益活清下法; 临床研究 　　Objective: To investigate the therapeutic effect of Yihuo Qingxia method, a traditional Chinese medicine therapeutic method for replenishing qi to activate blood, clearing away heat and dredging intestines, in treating hyperlipoidemiarelated severe acute pancreatitis (SAP) in early stage. 　　Methods: One hundred and four patients with hyperlipoidemiarelated SAP were divided into two groups: early group (admitted to hospital within 3 days after onset) and late group (admitted to hospital from 3 days to 7 days after onset). There were 52 cases in each group. All the patients were treated by Yihuo Qingxia method. 　　Results: There were no statistical differences in 48hour Ranson scores, CT scores, 24hour acute physiology and chronic heath evaluationⅡ scores (APACHE Ⅱ scores), and the levels of 24hour serum triglyceride (TG) and serum glucose in the two groups (P0.05). At the 10th day after onset, the serum TG level in early group was lower than that in late group (P0.01). The incidences of acute respiratory distress syndrome, acute renal failure, hepatic inadequacy, congestive heart failure, shock, encephalopathy, infection and alimentary tract hemorrhage in early group were higher than those in late group (P0.05). The mortality in early group was lower than that in the late group (P0.05). The length of hospital stay in early group was shorter than that in late group (P0.05). 　　Conclusion: Yihuo Qingxia method has a good efficacy in treating hyperlipoidemiarelated SAP in