生大黄水浸液灌胃、芒硝外敷联合西药治疗重症急性胰腺炎临床研究

Clinical Study on Rhei Radix et Rhizoma Water Extract Gavage and External Application of Sulfas Natrii Combined with Western Medicine for Severe Acute Pancreatitis

目的:观察生大黄水浸液灌胃、芒硝外敷联合西药治疗重症急性胰腺炎(SAP)腑实热结证的临床疗效。方法:选取82例SAP腑实热结证患者,依据随机数字表法分为对照组、观察组各41例。对照组给予西药治疗,观察组在对照组基础上联合生大黄水浸液灌胃与芒硝外敷进行治疗,2组均治疗10 d。比较2组临床疗效、临床症状改善时间及血清淀粉酶(AMS)、二胺氧化酶(DAO)水平。结果:治疗后,观察组总有效率97.56%,高于对照组80.49%,差异有统计学意义(P<0.05)。观察组腹痛缓解、腹胀缓解、肠鸣音恢复时间及首次排便时间均短于对照组,差异均有统计学意义(P<0.05)。2组血清AMS、DAO水平均较治疗前降低,观察组血清AMS、DAO水平均低于对照组,差异均有统计学意义(P<0.05)。结论:在西药基础上加用生大黄水浸液灌胃联合芒硝外敷治疗SAP腑实热结证,可缓解胃肠损伤,缩短临床症状改善时间。

Objective:To observe the clinical effect of the therapy of Rhei Radix et Rhizoma Water Extract Gavage and external application of Sulfas Natrii combined with western medicine on severe acute pancreatitis(SAP)with syndrome of bowel excess and heat bind.Methods:A total of 82 SAP patients with syndrome of bowel excess and heat bind were selected and divided into the control group and the observation group according to random number table method,with 41 cases in each group.The control group was treated with western medicine,and the observation group was additionally treated with Rhei Radix et Rhizoma Water Extract Gavage and external application of Sulfas Natrii based on the treatment of the control group.Both groups were treated for 10 days.The clinical effects,improvement time of clinical symptoms and levels of serum amylase(AMS)and diamine oxidase(DAO)were compared between the two groups.Results:After treatment,the total effective rate was 97.56%in the observation group,higher than that of 80.49%in the control group,difference being significant(P<0.05).The abdominal pain relief time,abdominal distension relief time,bowel sound recovery time and the first defecation time in the observation group were shorter than those in the control group,differences being significant(P<0.05).The levels of serum AMS and DAO in the two groups were decreased when compared with those before treatment,and the above two levels in the observation group were lower than those in the control group,differences being significant(P<0.05).Conclusion:The additional application of Rhei Radix et Rhizoma Water Extract Gavage and external application of Sulfas Natrii based on western medicine for SAP with syndrome of bowel excess and heat bind,can relieve gastrointestinal injury and shorten the time of clinical symptom improvement.