大柴胡汤治疗肝郁气滞型急性轻症胰腺炎的临床观察

Effect of Dachaihu Decoction in Treating Acute Mild Pancreatitis of Gan-qi Stagnant Type

目的观察大柴胡汤对肝郁气滞型急性轻症胰腺炎的疗效。方法将36例肝郁气滞型急性轻型胰腺炎患者随机分为单纯西医治疗组(A组)、西医治疗加中药安慰剂组(B组)和西医治疗加大柴胡汤组(C组),每组各12例。A组仅采用西医常规治疗;B组在西医常规治疗的基础上,加用与中药汤剂具有相同感外观口的安慰剂每天1剂口服;C组在西医常规治疗的基础上,加用大柴胡汤每天1剂口服治疗;3组观察疗程均为7天。观察患者腹痛缓解时间、禁食时间以及住院总时间;检测治疗前及治疗后不同时间点患者血清胰淀粉酶、C反应蛋白水平。结果各组血清胰淀粉酶和C反应蛋白水平治疗后较治疗前均降低(P<0.05,P<0.01)。C组与A组、B组比较,治疗第1、3、5天血清胰淀粉酶,治疗第1、3、5、7天C反应蛋白水平均明显降低(P<0.05);C组腹痛缓解时间、禁食时间及住院时间均短于B、C组(P<0.05,P<0.01)。结论在西医常规治疗上加服中药大柴胡汤能显著缩短急性轻症胰腺炎的病程时限,并提高临床疗效。

Objective To observe the therapeutic effect of Dachaihu Decoction （DCHD） on acute mild pancreatitis of Gan-qi stagnant syndrome type. Methods Thirty-six acute pancreatitis patients were randomized into three groups （Group A, B and C） equally, and they were treated with conventional Western medicine （WM）, WM plus placebo and WM plus DCHD, respectively for 7 days. The time for pain relieving, fasting and total hospitalization were observed, and serum amylopsin and C-reactive protein （CRP） levels were measured before treatment and at various time points after treatment. Results After treatment, amylopsin and CRP level significantly decreased in the 3 groups, comparing with those before treatment （P 〈 0.05, P 〈 0.01 ）. In Group C, amylopsin level was obviously higher on dl , d3 and d5, CRP level was higher on dl , d3, d5 and d7, and the remission time of abdominal pain, the fasting time, as well as the hospitalization time were all significantly shorter than those in Group A and B （P 〈 0.05, P 〈 0.01 ）. Conclusion The accessory use of DCHD upon conventional Western medical treatment can strikingly shorten the course of disease and enhance the therapeutic effect on mild acute pancreatitis patients.