大黄治疗重症急性胰腺炎的临床应用观察

Observe the Clinical Application of Rhubarb treatment on SAP

目的观察大黄治疗重症急性胰腺炎(severe acute pancreatitis,SAP)的疗效,探讨重症急性胰腺炎的有效治疗方法。方法 98例SAP患者,均符合中华医学会消化病学分会胰腺疾病学组的SAP诊断及分级标准,随机分为两组,早期大黄治疗组(简称治疗组)和常规治疗组(对照组),并对其进行临床对比观察。结果治疗组较对照组,腹痛消失时间、肠鸣音恢复时间、腹胀缓解时间明显缩短(p<0.05);血淀粉酶下降较快(p<0.05);APACHEⅡ积分至第1周与对照组相比差异即有统计学意义(P<0.05);至第10天时差异非常显著(P<0.01);并发症发生率、感染发生率、临床治愈时间、治愈率及死亡率有非常显著差异(p<0.01)。结论早期应用大黄治疗重症急性胰腺炎能显著缓解临床表现,控制病情,缩短治疗时间,提高治愈率,明显降低并发症发生率、感染发生率及死亡率,改善SAP的预后。

Objective To investigate the curative effects of rhubarb on serve acute panereatitis （SAP） and to expore effective therapeutic methods of SAP. Methods 98 cases conformd to the Chinese medical association digestion branch disease diagnosis and classification standard of SAP and divided into group 1 treated with rhubarb early （therapeutic group） and group 2 with conventional therapy（ control group）. And observe their clinical curative effects. Results Contrast to control group,the release time of abdominal pain and abdominal distensio,the recovery time of borborygmus in therapeutic group were shortened （ P 〈 0. 05 ） ;The hemo-diastase decreased more quickly than control group;Contrast to control group,The integral calculus of APACHE 11 in therapeutic group in the first week had statistical significance （P 〈0.05）and to the tenth day had great statistical significance（ P 〈 0. 01 ） ;The incidence rate of complication and infection ,the clinical cure time ,the cure rate and the mortality bad great statistical significance（ P 〈 0. 01 ）. Conclusions In SAP, The early use of rhubarb can relieve clinical situation,control pathogenetic condition,shorten time of therapy,increase cure rate ;can greatly decrease the incidence rate of complication and infection and decrease mortality;and can improve patient＇s prognosis.