中西医结合治疗老年急性重症胰腺炎的临床研究

Clinical Study of Elder Severe Acute Pancreatitis Treated Bytraditional Chinese Medicine Combined with Western Medicine

目的探讨中西医结合治疗老年重症急性胰腺炎(Elder sever acute pancreatitis,ESAP)的临床疗效。方法回顾性分析我院1997年1月至2007年1月间收治的52例≥60岁SAP患者的临床资料,其中经常规西医治疗(对照组)26例,中西医结合治疗(治疗组)26例。结果治疗组1周APACHEⅡ评分为(8.8±1.9),2周Balthaza CT评分为(3.3±1.2),血淀粉酶降至正常时间(4.6±2.4)d,住院时间(58.2±11.6)d,对照组对应指标为(11.2±2.5),(4.8±1.6),(6.9±1.6)d,(71.6±8.6)d,2组差异有统计学意义Ρ<0.005,P<0.01,P<0.005,P<0.001。治疗组手术干预率7.7%(2/26),严重并发症发生率23.1%(6/26),严重腹胀发生率46.2%(12/26),病死率23.1%(6/26),对照组对应指标30.8%(8/26),61.5%(16/26),76.9%(20/26),50.0%(13/26),2组差异均有统计学意义P<0.05。结论中西医结合治疗ESA P能加快降低血淀粉酶,降低1周APACHEⅡ评分和2周Balthaza CT评分,降低手术干预率,严重并发症发生率及病死率,疗效优于常规西医治疗。

Objective To investigate the clinical therapeutic effect of elder severe acute pancreatitis （ESAP） treated by traditional Chinese medicine combined with western medicine. Methods To analyze the clinical data of the 52 ESAP patients（≥ 60 years old） retrospectively in our hospital from January 1997 to January 2007,26 in the treat group were treated by traditional Chinese medicine combined with western medicine,and 26 in the control group were treated by western medicine. Results In the treat group,after 1 week the APACHE II score was（8.8 ± 1.9）,after 2 weeks,Bathazar CT score（3.3 ± 1.2）,the time of hemediastase drop to normal （4.6 ± 2.4）days,the length of stay（58.2 ± 11.6）days,and those in the control group were（11.2 ± 2.5）,（6.9 ± 1.6）,（71.6 ± 8.6）.The differences between the treat group and the control group were statistical significance,P〈0.005,P〈0.01 P〈0.005,P〈0.001 .Operation intervention7.7% （2/26）, severe complication（include shock, ARDS, renal inadequacy,Hepatic failure, congestive heart failure, pancreatic encephalopathy, pulmonary infection, pancreas pseudocyst） 23. 1%（6/26）,severe abdominal distension 46.2%（12/26）, fatality23 .1%（6/26）,and those in the control group were30.8%（8/26）, 61.5%（16/26）, 76.9%（20/26）, 50.0%（13/26）, The differences between the treat group and the control group were not statistical significance（P〈0.05）.Conclusion The conbined treatment of traditional Chinese medicine and western medicine can shorten the time of hemodiastase drop to normal, shorten the time of stay, cut down l week the APACHE Ⅱ score and after 2 weeks Bathazar CT score, operation intervention ,severe complication and fatality. The curative effect surpass only western medicine.