赤芍煎剂治疗重症急性胰腺炎随机对照临床探究.doc

赤芍煎剂治疗重症急性胰腺炎随机对照临 床探究 作者：张敏，朱德增，李兆申，湛先保 【摘要】比较赤芍煎剂和生大黄治疗早期重症急性胰腺 炎（severe acute pancreatitis, SAP）的临床疗效。方法： 将符合SAP诊断标准的96例患者随机分成两组。对照组48 例，应用常规西医疗法加用生大黄15-30 g开水泡制150 ml， 胃管内注入后夹闭胃管30?60 min, 2次/d,必要时加以灌 肠；治疗组48例，在西医疗法基础上加用赤芍煎剂，用法 同对照组。观察指标：腹胀、发热、腹部压痛消失时间；抗 生素、胰酶抑制剂、蛋白酶抑制剂应用时间；发病至肠内营 养应用时间、鼻空肠营养时间;冃肠减压时间、禁食时间; 养应用时间、鼻空肠营养时间; 冃肠减压时间、禁食时间; 平均住院日、住院费用及死亡率；两组中药应用过程中的不 良反应等。结果：治疗组患者的腹部压痛、腹胀、发热时间 均少于对照组（Plt；0?05）；治疗组应用抗细菌药物、抗真 菌药物的时间短于对照组（Plt；0.05）；两组抑制胰腺分泌 药物及蛋白酶抑制剂应用时间比较，差异无统计学意义 （Pgt；0. 05）;治疗组的患者可以更快地耐受鼻空肠内营 养，其肠内营养时间、胃肠减压时间及禁食时间均短于对照 组，治疗组住院时间及费用均少于对照组（Plt；0?05）。两 组死亡率及用药副反应比较，差异亦无统计学意义 (Pgt；O. 05)o结论：赤芍煎剂同单味生大黄比较，其治疗 SAP的疗效更明显，病人耐受程度好。 【关键词】急性坏死性胰腺炎；中医疗法；中西医结合; 赤芍；大黄 Objective： To compare the therapeutic effects of red peony root decoction, a compound traditional Chinese herbal medicine, and rhubarb in treating severe acute pancreatitis (SAP)?Methods： A total of 96 consecutive patients with objectively graded SAP were randomly divided into treatment and control groups? There were 48 cases in each group? The patients in the treatment and control groups were assigned to receive red peony Toot decoction and rhubarb treatment 1 2 times a day via a gas trie tube respec ti vel y. Comparisons in the time needed for the disappearance of abdominal tenderness, fever and abdominal distension were made between the two groups? The total days of using antibiotics, enzyme inhibitor, protease inhibitor, and nasojejunal feeding start, nasojejunal feeding, gastrointestinal decompression, fasting diet were also compared? And comparison also included hospital stays and hospitalization costs.Results： The durations of abdominal tenderness, fever and abdominal distension in the treatment group were less than those in the control group (Plt；0?05)? Compared with the control group, the time length for antibiotics (including anti bacteria drug and antifungal agent) use, nasojejunal feeding start, nasojejunal feeding, gastrointestinal decompression, fasting diet, hospital st ays and hospital