血必净联合清胰汤治疗重症急性胰腺炎疗效观察

摘要

Objective To observe the clinical effect of Xuebijing injection combined with Qingyi decoction for treatment of patients with severe acute pancreatitis(SAP). Methods A total of 80 patients of SAP in our hospital were randomly divided into treatment group and control group(each,40 cases). Conventional treatment was given to the two groups,the treatment group additionally was treated by Xuebijing 100 ml intravenous injection,twice a day, and at the same time,Qingyi decoction(radix bupleuri,scutellaria root,white peony,corydalis tuber,rhubarb, mirabilite,etc.)jejunum enema(one dose per day,daily 200 ml juice divided into 4 times to be administered into the jejunal tube)was applied. The changes of the rat of complication,the rate of transfer to perform operation,mortality, duration of abdominal pain,time for hospitalization,blood amylase(AMS)recovery time and acute physiology and chronic health evaluation system Ⅱ(APACHEⅡ)score were observed in the two groups. Results In treatment group,the complication rate(10.0%),transfer operation rate(5.0%)and mortality(2.5%)were significantly lower than those of the control group(47.5%,32.5% and 20.0%,all P<0.05). The duration of abdominal pain(day:8.4±2.9),the hospitalization time(day:24.2±6.8)and blood AMS recovery time(day:21.8±7.1)in treatment group were significantly shorter than those of the control group(13.3±5.8,25.1±7.2,6.9±6.7,all P<0.05). APACHEⅡ had no statical difference compared with two groups after treatment(7.95±5.40 vs. 5.13±1.95,P>0.05) Conclusion Xuebijing injection combined with Qingyi decoction for treatment of SAP can reduce the rate of complication,the number of cases necessary to be operated,shorten the hospitalization time and decrease the mortality.%　　目的观察中药血必净注射液联合清胰汤治疗重症急性胰腺炎（SAP）的临床疗效。方法将本院收治的80例SAP患者按随机原则分为治疗组（40例）和对照组（40例）。两组均给予常规治疗；治疗组加血必净注射液100 ml静脉滴注，每日2次，同时给予清胰汤（柴胡、黄芩、白芍、延胡索、大黄、芒硝等）空肠灌肠（每日1剂，取汁200 ml，分4次从空肠管注入）。分别观察两组患者并发症发生率、转手术率、病死率、腹痛持续时间、住院时间、血淀粉酶（AMS）恢复时间和急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分的变化。结果治疗组并发症发生率（10.0%）、转手术率（5.0%）和病死率（2.5%）均明显低于对照组（47.5%、32.5%和20.0%，均P＜0.05）。治疗组腹痛持续时间（d：8.4±2.9）、住院时间（d：24.2±6.8）和血AMS恢复时间（d：21.8±7.1）明显短于对照组（13.3±5.8、25.1±7.2、6.9±6.7，均P＜0.05）；两组治疗后APACHEⅡ评分比较差异无统计学意义（分：7.95±5.40比5.13±1.95，P＞0.05）。结论血必净注射液联合清胰汤治疗SAP能减少并发症和手术例数，缩短住院时间，降低病死率。