生长抑素联合中药胰炎合剂治疗重症急性胰腺炎的疗效观察

Effect of Combined Therapy with Sandostatin and Yiyan Mixture in Treating Severe Acute Pancreatitis

目的观察生长抑素联合中药胰炎合剂治疗重症急性胰腺炎的疗效。方法36例重症急性胰腺炎患者,其中对照组18例,单纯采用生长抑素治疗;治疗组18例,采用生长抑素加胰炎合剂治疗。观察两组治疗前后血清乳酸脱氢酶(LDH)、门冬氨酸氨基转移酶(AST)、血淀粉酶(AMY),血清内毒素(ET)水平,C反应蛋白(CRP),急性生理学和慢性健康状态评分系统Ⅱ(APACHE Ⅱ)评分变化,及治疗后局部并发症发生率和病死率等。结果治疗后治疗组患者腹痛消失、腹胀消失、排气恢复、腹部压痛消失时间及平均住院天数较对照组明显缩短,两组比较差异有统计学意义(P<0.05)。治疗后两组血清LDH、AST、AMY、ET、CRP及APACHEⅡ评分均较治疗前下降,但治疗组下降幅度大于对照组,两组比较差异有统计学意义(P<0.05)。两组局部并发症及病死率差异无统计学意义(P>0.05)。结论生长抑素联合中药胰炎合剂治疗重症急性胰腺炎,可明显改善病情,缩短住院时间,提高治疗效果。

Objective To observe the efficacy of combined therapy with Sandostatin （SDS） and Yiyan Mix- ture （YYM） in treating severe acute pancreatitis （SAP）. Methods Thirty-six patients with SAP were assigned to two groups equally, the treated group treated with the combined therapy and the control group treated by SDS a- lone. Biochemical indexes, including lactate dehydrogenase （LDH）, aspartate aminotransferase （AST）, amylase （AMY）, endotoxin （ET）, C-reactive protein （CRP）, and APACHE Ⅱ score were determined before and after treatment. And the incidence of complication and mortality were assessed. Results The time of abdominal pain, tenderness and distention disappearance, air charge recovering, and average hospitalization days in the treated group were significantly shorter than those in the control group respectively （ P 〈 0.05 ）. Levels of LDH, AST, AMY, serum ET, CRP and APACHE Ⅱscores were lowered after treatment in both groups, but the decrement was more significant in the treated group than that in the control group respectively （ P 〈 0. 05 ）. The difference in inci- dence of local complications and mortality between the two groups showed no statistical significance （P 〉 0.05 ）. Conclusion Combined therapy of Sandostatin and YYM is a recommended recipe for treatment of SAP, it could obviously improve the condition of patients and enhance the efficacy of treatment.