DAR综合治疗早期急性胰腺炎的临床分析

Clinical study on combined use of dexamethasone,anisodamine and rhubarb in the treatment of early acute pancreatitis

目的初步观察DAR疗法[联合应用地塞米松(D)、山莨菪碱(A)和大黄(R)]治疗急性胰腺炎的临床效果。方法入选急性胰腺炎病例共205例。其中轻型急性胰腺炎患者142例,随机分为对照组(n=71)和治疗组(n=71);重症急性胰腺炎患者63例,随机分为对照组(n=32)和治疗组(n=31)。对照组采用常规治疗,治疗组在常规治疗的基础上联合应用地塞米松、山莨菪碱和大黄。结果 142例轻型急性胰腺炎患者,无论采用何种治疗方法均无一例死亡;63例重症急性胰腺炎患者,对照组32例有5例死亡,治疗组31例无一例死亡;无论轻型急性胰腺炎还是重症急性胰腺炎患者,腹痛缓解时间治疗组短于对照组,而治疗组和对照组间血淀粉酶恢复正常时间的差异无统计学意义。结论应用DAR疗法综合治疗早期急性胰腺炎,能够有效缓解腹痛、降低病死率。

Objective To observe the effect of combined use of dexamethasone,anisodamine and rhubarb on early acute pancreatitis （ AP） . Methods A total of 205 patients with AP were enrolled. Of them,142 patients with mild acute pancreatitis （ MAP） were randomly divided into control group （ n = 71） and treatment group （ n = 71） ; 63 patients with severe acute pancreatitis （ SAP） were also randomized into control group （ n = 32） and treatment group （ n = 31） . All patients in control groups were given standard treatment,and the patients in treatment groups received combined treatment of dexamethasone,anisodamine and rhubarb on the basis of standard treatment. Results None of MAP patients died. Among 63 SAP patients,5 died in control group,but no one died in treatment group. Both in MAP and SAP patients,the relief time of abdominal pain was significantly shorter in treatment group than in control group,but there was no significant difference in the recovery time of blood amylase between control group and treatment group. Conclusion The combined use of dexamethasone,anisodamine and rhubarb in the treatment of early AP can effectively relieve the abdominal pain and reduce the mortality.