大黄灌肠配合芒硝外敷辅治急性胰腺炎的临床观察

摘要

[Objective]To discuss the clinical efficacy of Rhubarb Enema and Glauber's salt Topical on acute pancreatitis.[Methods]Select in our hospital from April 2010 to April 2014 60 AP patients were randomly divided into two groups,n=30 for each.The treatment one was treated with Rhubarb Enema and Glauber's salt Topical on the basis of western medicine,the control group only received conventional western treatment.After 7 days,observe clinical symptoms and laboratory parameters changes,e.g.exhaust defecation, bowel sounds, serum amylase and C-reactive protein,and compare the two groups before and after the treatment of APACHEⅡand BISAP score. [Result] The clinical effective rate was 90% in treatment group and was better than the control group 73.33%,the difference was obvious(P<0.05). Treatment group patients exhaust defecation,bowel sounds were obviously improved,serum amylase,c-reactive protein index decreased obviously(P<0.05). APACHEⅡand BISAP score index decreased obviously(P<0.05), the difference was all obvious for the treatment group.But there's no significant statistical differences between before and after treatment for the control group(P>0.05). [Conclusion]Rhubarb Enema and Glauber's salt topical treatment for acute pancreatitis have a significant effect.%[目的]探讨大黄灌肠配合芒硝外敷对急性胰腺炎（Acute Pancreatitis，AP）辅助治疗的临床疗效。[方法]选取诸暨市中医院从2010年4月至2014年4月收治的60例AP患者，随机分成治疗组和对照组，每组各30例，治疗组在西医常规治疗的基础上加用大黄灌肠配合芒硝外敷治疗，对照组则仅予西医常规治疗。治疗7d后观察两组的治疗效果。采用急性生理功能和慢性健康状况评分系统Ⅱ(acute Physiology and chronic health evaluationⅡ，APACHEⅡ)及标准床旁急性胰腺炎严重度评分(bedside index for severity in AP，BISAP)对患者进行评估，记录患者排气排便、肠鸣音恢复情况，监测血清淀粉酶及CRP指标变化，比较两组治疗前后APACHEII、BISAP评分。[结果]治疗组临床有效率为90%，明显优于对照组的73．33%，差异有统计学意义（P<0．05）；治疗组患者排气排便次数、肠鸣音均得以明显改善，血清淀粉酶、C反应蛋白指标明显下降，差异有统计学意义（P<0．05），APACHEII、BISAP评分明显下降，差异有统计学意义（P<0．05）；两组治疗前后排气排便次数、肠鸣音、血清淀粉酶、C反应蛋白指标、APACHEII、BISAP差值比较，差异均有统计学意义（P<0．05）。[结论]大黄灌肠配合芒硝外敷辅助治疗，可有效缓解AP患者腹痛、排气排便等临床症状，降低炎症反应。