威灵仙辅助大黄治疗重症急性胰腺炎肠屏障功能障碍作用研究

Research on Effect of Clematis Chinensis Co-Operate with Rhubarb Treatment for Patients of Intestinal Barrier Dysfunction Caused by Severe Acute Pancreatitis

目的：探讨威灵仙配合大黄对恢复重症急性胰腺炎（SAP）肠屏障功能所起的作用。方法：将符合重症急性胰腺炎肠屏障功能障碍患者随机分组，对照组A组给予西医常规治疗加大黄煎水经鼻空肠管注入，治疗组B组给予西医常规治疗加大黄合威灵仙煎水经鼻空肠管注入。观察两组患者治疗前及治疗3、7d时的APACHEII评分和BalthazarCT评分；血淀粉酶、CRP恢复正常时间；肠鸣音（大于3次／min）出现时间；腹痛缓解时间；腹胀缓解时间；首次排便时间；重症监护病房（ICU）停留时间；并发症发生率和死亡率。结果：治疗后3、7d，B组的APACHEII评分和BalthazarCT评分均低于A组（P〈0．05）；B组的肠鸣音（大于3次／min）出现时间、腹痛缓解时间、腹胀缓解时间、首次排便时间、重症监护病房（ICU）停留时间较对照组短（P〈0．05～0．01）。结论：治疗组B组（威灵仙合大黄）能更有效地缓解重症急性胰腺炎（SAP）患者的病情，在恢复SAP肠屏障功能方面比对照组A组效果更加显著。

Objective： To explore the effect of rhubarb with Clematis chinensis （ Weilingxian ）treatment for the patients of intestinal harrier dysfunction （ IBD ） caused by severe acute panereatitis （ SAP ）. Methods ： Fifty-one patients of IBD caused by SAP were randomly divided into group A （ n--25 ） and B （ n=26 ）. Based on comprehensive treatment, the patients in group A were given rhubarb by endoscopic nasojejunal feeding, while those in group B were given rhubarb with Clematis chinensis. The acute physiology and chronic health evaluation Ⅱ （ APACHE Ⅱ ） score and Bahhazar CT score hefore treatment and 3,7 days after treatment were observed and compared. Besides, serum amylase and C-reactive protein （ CRP ） levels, the remission time of abdominal pain and distension, the time of bowel sound happened, the time of shit excreted, length of stay in ICU, complication incidence as well as mortality were also observed. Results ： Three days and seven days after treatment, the APACHE Ⅱ and Bahhazar CT score in group B were lower than those in group A （ P〈0.05 ）. The restore of normal serum amylase and CRP levels, the time of bowel sound happened, the time of shit excreted, length of stay in ICU, remission time of abdominal pain and distension in group B were significant shorter than those in group A （ P〈0.05, P〈0.01 ）. Conclusion ： Administration of rhubarb with Clematis chinensis is more effective on IBD of SAP as auxiliary treatment.