生长抑素联合柴芍承气汤鼻饲和生大黄灌肠治疗重症急性胰腺炎50例分析

The effects of Chaishaochengqi decoctiom by nasogastric feeding and Rhubarb by enema combined with somatostastin on 50 cases of severe acute pancreatitis

目的探讨应用生长抑素联合柴芍承气汤鼻饲和生大黄灌肠治疗重症急性胰腺炎(SAP)的临床疗效。方法将符合SAP诊断标准的100例患者按数字表随机分成2组,对照组50例应用常规西医治疗方法(包括加强监护、禁食、胃肠减压、应用生长抑素、抗感染等);治疗组50例在常规治疗基础上应用柴芍承气汤鼻饲和生大黄灌肠。观察两组腹痛、腹胀症状消失时间,心率、呼吸恢复正常时间,血淀粉酶、血糖恢复正常时间及死亡率比较。结果治疗组腹痛、腹胀症状消失时间及心率、呼吸恢复正常时间均快于对照组,差异有统计学意义(P<0.05);两组血淀粉酶、血糖恢复正常时间比较差异无统计学意义(P>0.05)。治疗组病死率低于对照组,差异有统计学意义(P<0.05)。结论应用生长抑素联合柴芍承气汤鼻饲和生大黄灌肠治疗SAP,可更快改善患者腹痛、腹胀症状,恢复心率、呼吸,降低死亡率。血淀粉酶、血糖恢复正常时间无差异。

Objective To observe the therapeutic effect of Chaishaochengqi deeoetiom by nasogastric feeding and Rhubarb by enema combined with somatostastin on severe acute pancreatitis （SAP）. Methods One hundred patients with SAP were randomly divided into two groups. The control group （n= 50） was treated with conventional therapy （intensive care, fasting, gastrointestinal decompression, somatostatin, antibiotics）. The treatment group （n= 50） was treated with Chaishaochengqi decoctiom by nasogastric feeding and Rhubarb by enema combined with somatostastin. The extinction time of abdominal pain and abdominal distension, the reviving time of heart rate and respiration rate, serum biochemical criteria （amylase, blood glucose） and mortality were observed and compared. Results The extinction time of abdominal pain and abdominal distension, the reviving time of heart rate and respiration rate in treatment group were all shorter than those in control group （P〈0.05）, and the mortality was significantly lower. There was no statistical difference in the reviving time of blood amylase and blood glucose between the two groups （P〉0.05）. Conclusion Chaishaochengqi decoctiom by nasogastric feeding and Rhubarb by enema combined with somatostastin can quickly improve the syndromes of abdominal pain and abdominal distension,retrieve the normal heart rate and respiration rate, and reduce mortality. It exerts no effect on the reviving time of blood amylase and blood glucose.