甘遂治疗重症急性胰腺炎腹内高压的疗效观察

Kansui root therapy for severe acute pancreatitis with high intra-abdominal pressure

目的 观察中药甘遂辅助治疗重症急性胰腺炎（SAP）并发腹腔间隔室综合征（ACS）的疗效.方法 收集SAP并发ACS患者16例,按随机数字表法分为甘遂组和对照组.对照组按常规行禁食、抗休克、抗感染、营养支持等治疗,甘遂组在对照组治疗方案基础上加用甘遂.对比两组临床和实验室指标、结果甘遂组腹痛缓解时间、肠呜音恢复时间、血淀粉酶恢复正常时间及体温、白细胞计数恢复正常时间分别为（7.6±2.3）d、（6.1±3.1）d、（5.9±3.3）d、（5.2±3.2）d、（6.3±2.1）d,较对照组的（1 1.7±2.1）d、（11.2±2.3）d、（10.2±2.7）d、（9.2±3.5）d、（11.1±3.3）d有显著差异（P＜0.01）;治疗后第3、4、5天两组病例腹内压差异显著[（19.8±3.1）cmH2O对（23.7±2.9）cmH2O、（12.3±2.7）cmH2O对（21.3±1.5）cmH2O、（8.2±3.1）cmH2O对（17.3±2.3）cmH2O,P值均＜0.05].结论 胰腺炎与中医结胸证有密切相关性,甘遂能够有效降低SAP所致的腹内高压.

Objective To investigate the treatment effects of Kansui root on severe acute pancreatitis （SAP） with abdominal compartment syndrome （ACS）.Methods 16 cases of SAP were randomly divided into kansui root treatment group and control group according to random number table.Patients in control group received routine treatment including fasting, anti-shock, antibiotics and nutritional support.And the patients in kansui root group received routine treatment plus kansui root therapy.The clinical and laboratory parameters were determined and compared between the two groups.Results The relieving time of abdominal pain, bowel sound, the recovery time of hyperamylasemia, body temperature and leukocyte count in treatment group was （7.6±2.3）d, （6.1 ±3.1）d, （5.9±3.3）d, （5.2 ±3.2） d, （6.3 ±2.1）d, which were significantly shorter than those in control group [ （ 11.7 ± 2.1 ） d, （ 11.2 ± 2.3d, （ 10.2 ± 2.7） d, （9.2 ± 3.5 ） d, （ 11.1 ±3.3）d, P〈0.01 ） ].At the 3rd, 4th and 5th day, the intra-abdominal pressure in treatment group were also significantly lower than those in control group[ （ 19.8 ±3.1 ）cmH2O vs（23.7 ±2.9） cmH2O, （ 12.3 ±2.7） cmH2O vs （21.3±1.5）cmH2O,（8.2±3.1）cmH2O vs （17.3 ±2.3）cmH2O,P〈0.05].Conclusions Severe acute pancreatitis has close relationship with Jiexiong syndrome in traditional chinese medicine.Kansui root is an effective therapy for alleviating high intra-abdominal pressure.