大黄通便颗粒与生大黄治疗重症急性胰腺炎的疗效比较

摘要

Objective:To compare the effect of rhubarb laxative particles and rhubarb on the treatment of se-vere acute pancreatitis(SAP).Method:SAP patients included 74 cases with prospective and continuity,which were randomly divided into rhubarb laxative particles group (n=34)and rhubarb group (n=40).On the basis of routine treatment,rhubarb group with rhubarb soaked nasal-jejunal tube poured rhubarb laxative group nasal-jejunal tube poured.They were treated for one week.Two groups were compared serum amylase (AMS),serum lipase (LPS) to the required recovery time and the time of abdominal pain,constipation times the normal reference values.Two groups of patients before and after treatment were campared with Ranson score,CTSI score,BISAP score,SAPSⅡscore,APACHEⅡ score and clinical efficacy.Results:Compared with rhubarb group,patients in rhubarb laxative particle group APN,IL-6,PCT,AMS returned to normal reference range was significantly shorter (P <0.05),the first defecation time earlier (P <0.05).After treatment APACHEⅡ,CTSI,Ranson three scale scores were lower than before treatment (P <0.05 ),rhubarb particles group were decreased more significantly (P <0.05 ).Conclu-sion:Rhubarb laxative is better than rhubarb with the effect of particle therapy in SAP.%目的：：比较大黄通便颗粒和生大黄协同常规方法治疗重症急性胰腺炎(SAP)的临床疗效。方法：前瞻性、连续性纳入74例 SAP 患者,随机分为生大黄治疗组(生大黄组,n=40)和大黄通便颗粒治疗组(大黄颗粒组, n=34)。在常规治疗基础上,生大黄组以生大黄泡水经鼻-空肠管灌入；大黄颗粒组以大黄通便颗粒悬液经鼻-空肠管灌入治疗,均2次/日,持续治疗一周后,比较两组患者血清淀粉酶(AMS)、血清脂肪酶(LPS)等指标恢复至正常参考范围所用时间及腹痛缓解时间、通便时间等的差异,比较两组患者治疗前后 Ranson 评分、CT 严重程度指数评分(CTSI 评分)、急性胰腺炎严重程度床边指数评分(BISAP 评分)、简化急性生理学评分(SAPSⅡ评分)、急性生理与慢性健康评分(APACHEⅡ评分)及临床疗效。结果：与生大黄组相比,大黄颗粒组患者脂联素(APN)、白细胞介素-6(IL-6)、降钙素原(PCT)、AMS 恢复至正常参考范围所用时间明显较短(P <0.05),初次排便时间较早(P <0.05)。两组治疗后 APACHEⅡ、CTSI、Ranson 三项量表评分均较同组治疗前降低(P <0.05),大黄颗粒组比生大黄组降低更明显(P <0.05)。大黄颗粒组患者临床有效率和总有效率明显高于生大黄组(P <0.05)。结论：大黄通便颗粒治疗 SAP 疗效优于生大黄。