复方丹参注射液辅助治疗重症急性胰腺炎的临床疗效研究

摘要

目的：观察复方丹参注射液辅助治疗重症急性胰腺炎（Severe Acute Pancreatitis，SAP）的临床疗效。方法：将本院收治的50例 SAP 住院患者为研究对象，并根据入院先后顺序随机分为对照组和治疗组，2组患者均接受内科常规治疗，如禁食、胃肠减压、扩容、纠正电解质紊乱、抗感染、抑制胰腺分泌、营养支持等，治疗组在上述常规治疗基础上加用复方丹参注射液20 mL 联合0.9％Nacl 溶液250 mL 静脉滴注，每日1次。2组均以10 d 为1个疗程，1个疗程结束后观察2组患者治疗前后症状、体征以及实验室指标的变化。结果：1）治疗组首次排便的时间、肠鸣音恢复时间、腹部压痛消失时间均短于对照组，且差异有统计学意义（P ＜0.05）；2）2组并发症发生率、外科手术中转率及病死率比较均具统计学意义（P ＜0.05）；3）治疗组治疗组血浆内毒素、血清淀粉酶、白细胞计数恢复正常的时间均短于对照组（P ＜0.05），经过治疗后治疗组血清肿瘤坏死因子-α（Tumor Necrosis Factor alpha，TNF-α）、白细胞介素-8（Interleukin-8，IL-8）、白细胞介素-6（Interleu-kin-6，IL-6）水平明显低于对照组（P ＜0.05）。结论：复方丹参注射液辅助治疗 SAP 可促进胃肠功能恢复，降低并发症发生率及病死率，临床可进一步推广。%Objective:To observe the clinical curative effect of the compound salvia miltiorrhiza injection in adjuvant therapy of severe acute pancreatitis (SAP).Methods:Fifty patients with SAP were received and treated in our hospital.They were randomly divided into the control group and the treatment group.Both groups received conventional treatment,i.e.fasting,gastrointestinal de-compression,expansion of blood volume,correction of electrolyte disturbances,anti-infection therapy,inhibition of pancreatic secre-tion,nutritional support,etc.On top of conventional treatment,the treatment group received intravenous drip of 20 ml compound sal-via miltiorrhiza injection combined with 250ml 0.9% NaCl solution,once per day.Both groups received 10 days of treatment,and were observed of the changes in symptoms,signs and laboratory indexes before and after treatment.Results:1 )First defecation time,bowel sound recovery time,and abdominal tenderness disappear time of the treatment group were shorter than that of the con-trol group,and the differences were statistically significant (P <0.05);2)Complications rate,surgical operation rate and case fa-tality rate of the two groups were with statistical differences (P <0.05);3)In the treatment group,the time of plasma endotoxin, serum amylase,the leukocyte count all returned to normal,which were better than that of the control group (P <0.05).After treat-ment,serum Tumor Necrosis Factor alpha (TNF alpha),interleukin-8 (IL-8)and interleukin-6 (IL-6)level of the treatment group were significantly lower than that of the control group (P <0.05).Conclusion:The application of compound salvia miltiorrhiza in-jection in the adjuvant therapy of SAP can promote the recovery of gastrointestinal function and reduce the incidence of complica-tions and case fatality,thus is suggested to be further promoted in clinical practice.