大承气汤合大柴胡汤加减辅助治疗急性中重症胰腺炎的临床观察

摘要

目的 探究大承气汤合大柴胡汤加减辅助治疗急性中重症胰腺炎的临床疗效.方法 收集2016年5-12月我院消化科及ICU的68例急性中重症胰腺炎患者,采用随机分组法分为治疗组和对照组,每组34例.对照组应用常规西药治疗,治疗组在常规西药治疗基础上加用大承气汤合大柴胡汤加减辅助治疗,疗程均为10 d.观察比较两组患者腹痛缓解时间、首次排便时间,以及治疗前后CRP、血淀粉酶、全腹CT的变化.结果 对照组、治疗组总有效率分别为70.59％、88.24％(P＞0.05);与对照组比较,治疗组腹痛缓解时间、首次排便时间明显缩短(P＜0.05);与治疗前比较,两组治疗后CRP、血淀粉酶均明显下降(P＜0.05),其中治疗组CRP下降更为显著(P＜0.05).结论 大承气汤合大柴胡汤加减可明显缓解患者腹痛症状,促进排便,恢复肠道运动功能,并具有良好的抗炎作用,疗效可靠.%Objective To observe the clinical effect of Dachengqi decoction combined with Dachaihu decoction on moderately severe and severe acute pancreatitis (MSAP &SAP).Methods Totally 68 patients with MSAP or SAP who were treated in the gastroenterology department or ICU in our hospital from May 2016 to December 2016 were selected.They were randomly divided into treatment group and control group,34 cases in each group.Control group was treated with routine Western medicine,while treatment group was treated with Dachengqi decoction combined with Dachaihu decoction on the basis of routine Western medicine treatment;the course of treatment was 10 d.Abdominal pain relief time,the first defecation time and the changes of CRP,serum amylase and abdominal CT of the two groups were compared.Results The total effective rate of control group and treatment group were 70.59％ and 88.24％ (P ＞ 0.05).Compared with control group,abdominal pain relief time and the first defecation time of treatment group were significantly decreased (P ＜ 0.05).The level of CRP and serum amylase were significantly decreased in the two groups after treatment (P ＜ 0.05),and CRP of treatment group decreased more significantly than control group (P ＜ 0.05).Conclusion Dachengqi decoction combined with Dachaihu decoction can relieve abdominal pain,promote defecation,restore intestinal motility and has anti-inflammatory effect.