柴芍承气汤联合早期肠内营养对重症急性胰腺炎预后的影响

Effect of the Chaishao Chengqi decoction plus EN against SAP

目的:探讨柴芍承气汤联合早期肠内营养对重症急性胰腺炎预后的影响。方法:对74例重症急性胰腺炎患者随机分为对照组(37例)和观察组(37例)。对照组给予常规治疗;观察组在常规治疗的基础上,入院后立即给予柴芍承气汤,并对肠功能恢复者早期进行肠内营养。观察两组患者入院后7、14dAPACHE-II评分和BalthazarCT评分及入院后3、7、14d血清淀粉酶、血清白蛋白水平,腹胀缓解时间,并发症发生率,住院天数和住院费用等。结果:观察组入院后7dAPACHE-II评分(3.76±1.42),对照组APACHE-II评分(4.63±1.84),2组比较具有统计学意义(P<0.05),入院后14dAPACHE-II评分无统计学意义(P>0.05);观察组、对照组患者BalthazarCT评分在入院后7、14d分别为[(2.69±0.58)、(1.83±0.57)]、[(2.82±0.43)、(1.89±0.69)],比较无统计学意义(P>0.05),组内比较具有统计学意义(P<0.05);观察组、对照组血清淀粉酶在入院后3、7、14d分别为[(1054±304)、(524±104)、(282±73)]、[(1127±298)、(652±126)、(290±85)],入院后7d2组比较有统计学意义(P<0.05),3、14天比较无统计学意义(P>0.05);观察组、对照组血清白蛋白在入院后3、7、14d分别为[(36.2±3.14)、(29.7±3.27)、(39.3±3.01)]、[(35.8±2.88)、(28.5±3.56)、(36.2±2.87)],入院后3、7d比较无统计学意义(P>0.05),14d比较有统计学意义(P<0.05);观察组、对照组在腹胀缓解时间、并发症发生率、平均住院日、总住院费用分别为[(3.16±1.25)d、(11%)、(21.34±10.28)d、(4.4±1.2)万元]、[(4.56±1.37)d、(30%)(29.67±13.56)d、(5.6±2.3)万元],比较具有统计学意义(P<0.05)。结论:柴芍承气汤联合早期肠内营养能明显改善重症急性胰腺炎患者的预后,缩短住院时间,减少住院费用。

Objective： To investigate the effect of the Chaishao Chengqi decoction plus early enteral nutrition （EN） against the prognostic of severe acute pancreatitis （SAP）. Methods： 74 cases were randomly divided into the observation group （n=37） and the control group （n=37）. The control group was treated in routine ways, while the observation group was treated with Chaishao Chengqi decoction plus EN. Observed APACHE-Ⅱ score and the Balthazar CT score after the patients were admitted to hospital in 7 and 14 days, and serum amylase, serum albumin level, abdominal, distension and alleviate the time, incidence of complications, days of hospitalization, and hospitalization costs were observed in 3, 7 and 14 days. Results： After admitted to hospital 7 days, the APACHE-Ⅱ score of the two group was （3.76±1.42） and （4.63±1.84）, there was statistically significant between the two group. After admitted to hospital 14 days, APACHE-II score was no significant （P〉0.05） ; After admitted to hospital 7 days,14days, BalthazarCT score of the two group was [（2.69± 0.58）. （1.83 ± 0.57） ] and [ （2.82±0.43） （1.89± 0.69）] , there was no statistically significant （P〉 0.05 ） , within the group,there was statistically significant（P〉0.05）; After admitted to hospital 3days,7 days, 14days, the serum amylase of the two group was [ （ 1054±304 ）, （524 ±104）, （282 ± 73） ] and [ （1127 ±298）, （652 ±126）, （290 ±85） ] ,there was statistically significant between the two group after admitted to hospital 7 days, there was no statistically significant between the two group after admitted to hospital 3days,14days （P〉0.05） ; After admitted to hospital 3 days, 7days,14days, the serum albumin of the two group was [（36.2±3.14）, （29.7±3.27）, （39.3±3.01）] and [ （35.8±2.88）, （28.5 ±3.56）, （36.2 ±2.87）], After admitted to hospital 3days,7 days, there was no statistically significant between the two group （P〉0.05）, After admitted to hospital 14days, there was statistically significant between the two group （P〈0.05） ; the alleviate abdominal distention time, complication rates, average length of stay, total hospital costs of the two group was [ （3.16 ±1.25）d, （11%）, （21.34±10.28）d, （4.4±1.2）万元], [-（4.56±1.37）d, （30%）, （29.67± 13.56）d, （5.6±2.3）万元] , there was statistically significant（P〈 0.05）. Conclusion： The Chaishao Chengqi decoction plus EN can significantly improve the prognosis of severe acute pancreatitis patients, shorten hospital stay, and reduce hospital costs.