柴芩承气汤治疗重症急性胰腺炎

Chaiqin Chengqi Decoction in Treatment of Severe Acute Pancreatitis

目的:观察柴芩承气汤治疗重症急性胰腺炎的疗效及可能作用机制。方法:112例重症急性胰腺炎患者按随机数表法分为观察组(柴芩承气汤联合常规西药治疗)与对照组(常规西药治疗)各56例。比较两组患者中医证候疗效、胃肠功能恢复情况(肠鸣音恢复时间、禁食时间、灌肠时间、胃肠减压时间)、胃肠动力相关指标(胃动素、P-物质、消脂素、内皮素)变化。结果:观察组有效率低为96. 43%,对照组为83. 93%,两组有效率比较,差异有统计学意义(P <0. 05)。观察组肠鸣音恢复时间、肛门排气时间、肛门排便时间均短于对照组,差异均有统计学意义(P <0. 05)。观察组治疗后3 d、7 d胃动素高于对照组,消脂素、内皮素低于对照组,差异均有统计学意义(P <0. 05)。结论:柴芩承气汤治疗重症急性胰腺炎疗效显著,可明显促进患者胃肠功能恢复,其作用机制可能与改善胃肠动力有关。

Objective:To observe the efficacy and possible mechanism of Chaiqi Chengqi Decoction in treatment of severe acute pancreatitis.Methods :112 patients with severe acute pancreatitis were divided into observation group (Chaiqi Chengqi Decoction combined with western medicine)and control group (conventional western medicine treatment),with 56cases in each group,according to the random number table method.Comparison of TCM symptom efficacy,gastrointestinal function recovery (intestinal recovery time,fasting time,enema time,gastrointestinal decompression time),gastrointestinal motility related indicators [Motilin,Psubstance,cellulite,endothelin]changes were made.Results :The effective rate of the observation group was 96.43%,and that of the control group was 83.93%.The effective rate of the two groups was statistically significant (P <0.05).The recovery time of bowel sounds,anal exhaust time and anal defecation time in the observation group were shorter than those in the controlgroup,and the difference was statistically significant (P <0.05).The motilin levels in the observation group were higher than those in the control group at 3 and 7 days after treatment and the levels of cellulite and endothelin were lower than those in the'control group (P < 0.05).Conclusion:Chaiqi Chengqi Decoction has significant curative effect on severe acute pancreatitis,which can significantly promote the recovery of gastrointestinal function.The mechanism may be related to the improvement of gastrointestinal motility.