中西医结合与善宁在治疗重症急性胰腺炎的疗效及卫生经济学比较

Comparison of curative effect and medical economics with integrative chinese and western medicine combined and sandostatin in treating severe acute pancreatitis

目的通过复方丹参静脉滴注和清胰汤保留灌汤与善宁在治疗重症急性胰腺炎(SAP)疗效及卫生经济学价值的比较,探讨非手术治疗SAP的有效且价廉的方法。方法62名患者随机分为治疗组(复方丹参和清胰汤保留灌肠组)与对照组(善宁组)。对患者的临床症状改善时间,血清淀粉酶和血常规复常时间,住院天数和住院费用,最终死亡率进行比较,并比较治疗组入院后12h内实施清胰汤保留灌肠与12h后实施在临床疗效上的差异。结果治疗组在腹部压痛体征消除时间,首次排大便时间,恢复进食时间比对照组明显缩短,住院费用明显减少,差异显著(P<0.05),腹痛初步缓解时间、血清淀粉酶、血常规复常时间、住院天数无明显差异。入院后12h内实施清胰灌汤保留灌肠,其腹部压痛体征消除时间,恢复进食时间比12h后实施更有明显缩短(P<0.05)。两组最终病死率无显著差别。结论复方丹参和清胰汤保留灌肠,尤其早期实施保留灌肠,可明显改善SAP病情,卫生经济学比善宁更具有优势。对病死率的影响因样本少需进一步研究。

Objective To compare curative effect and medical economics with complex prescriptionsalvia miltionrhiza plus Chinese medicine Qing Yi Tang retention enema and sandostatin in treating severe acute pancreatitis （SAP）. Approach effective and cheap nonoperative treatment for SAP. Methods 62 patients were randomly divided into two groups. In treatment group, patients were treated with complex prescription salvia mihiorrhiza plus Qing Yi Tang retention enema. In control group, patients treated with Sandostafin. The time that clinical symptom remissed, hemodiastase level and blood routine fall to normal, hospital stay time and hospitalization expenses were compared in two groups. Also, patients treated with Chinese medicine Qing Yi Tang retention enema before and after 12 hours were compared in treatment group. Resuits The time that abdominal tenderness remissed, first defecation time, the time that recover eating ,hospital days were shorter in treatment group than in control group （P〈0.05）. No significant in the time of abdominal pain remissed, hemodiastase level and blood routine fall to normal, hospitalization expenses in two groups, it was significant different that the time that abdominal tenderness remissed and recover eating were shorter in patients treated with Qing Yi Tang retention enema before 12 hours than after 12 hours（P〈0.05）, but the death rate was not significant in these patients. Conclusion Treating with complex prescription salvnotmiltiorrhiza plus chinese medicine Qing Yi Tang retention enema, especially in SAP earlier period can improve curative effect, and it is cheap than Sandostatin Because samples were too few, its contribution to death rate needs to be studied fnrtherly.