生长抑素联合加味大黄承气汤治疗重症急性胰腺炎

Effect of Modified Dachengqi Decocotion Combined with Stilamir in Treatment of Severe Acute Pancreatitis

目的:观察生长抑素联合中药加味大黄承气汤、复方丹参注射液治疗重症急性胰腺炎的疗效。方法:40例重症急性胰腺炎患者,其中对照组20例,单纯采用生长抑素治疗;治疗组20例,采用生长抑素+加味大黄承气汤+复方丹参注射液。观察两组治疗前后急性生理学和慢性健康状态评分系统Ⅱ(APACHEⅡ)评分,血清淀粉酶、血清钙、白介素6(IL-6)、白介素10(IL-10)及白介素18(IL-18)水平的变化,及治疗后局部并发症的发生率和病死率等。结果:治疗后治疗组患者腹痛消失、腹胀消失、排气恢复及平均住院天数较对照组明显缩短,两组比较差异有统计学意义(P<0.05)。治疗后两组血清淀粉酶、白介素6、白介素18及APACHEⅡ评分均较治疗前下降,但治疗组下降幅度大于对照组(P<0.05)。血清钙浓度逐渐增加,且治疗组的增加幅度大于对照组(P<0.05)。两组血清IL-10随着治疗呈下降趋势,但治疗组血清IL-10水平在第10天后又有所增高,高于第5天水平,也高于同期对照组(P<0.05)。治疗组局部并发症发生率低于对照组(P<0.05),两组病死率差异无统计学意义。结论:生长抑素联合加味大黄承气汤及丹参注射液治疗重症急性胰腺炎,可提高治疗效果。

Objective： To investigate the effect of therapy with modified Dachengqi decocotion combined with stilamir in severe acute pancreatitis （SAP）. Method： Forty patients with SAP were randomly divided into two groups, the treated group treated with the combined therapy and the control group treated by stilamir alone. Serum amylase, calcium concentration, interleukin-6 （IL-6）, IL-10, IL-18 and acute physiology and chronic health evaluation 11 （APACHE 11 ） score were determined before and after treatment. And the incidence of complication and mortality were assessed. Result： The time of abdominal pain, distention disappearance, air charge recovering, and average hospitalization days in the treated group were significantly shorter than those in the control group respectively （P 〈 0.05）. Levels of serum amylase, IL-6, IL-18 and APACHE 11 scores were lower after treatment in both groups, level of serum calcium concentration were higher after treatment in both groups （P 〈 0.05）. Level of serum IL-10 were lowered after treatment in both groups, but it was higher at 10 days in the treated group again （P 〈 0.05）. The incidence of local complications in the treated group were significantly lower than those in the control group respectively （P 〈 0.05）. But the incidence of mortality between the two groups showed no statistical significance. Conclusion： Combined therapy of modified Dachengqi tang and stilamir is a recommended recipe in treatment of SAP, it could obviously improve the efficacy of treatment.