早期肠内营养联合柴芍承气汤在重症急性胰腺炎治疗中的临床研究

Clinical study of early enteral nutrition combined with Chaishao Chengqi decoction treating for severe acute pancreatitis

目的:探讨早期肠内营养(enteral nutrition)联合柴芍承气汤应用于重症急性胰腺炎(severe acute pancreatitis,SAP)的临床疗效。方法:回顾性分析我院42例SAP患者的治疗方法,根据治疗方法不同将SAP患者分为观察组(21例)和对照组(21例),对两组患者的疗效进行对比分析。结果:观察组和对照组患者治疗前的白细胞计数(WBC)﹑血糖﹑血淀粉酶﹑尿淀粉酶、C反应蛋白(CRP)以及降钙素原(PCT)等6项指标相比无明显差异(P>0.05),两组患者治疗后的6项指标均较各组治疗前指标明显降低,差异有统计学意义(P<0.05);观察组中患者治疗后的WBC、血糖、PCT与对照组中治疗后相比较,差异无统计学意义(P>0.05),而血淀粉酶﹑尿淀粉酶和CRP差异有统计学意义(P<0.05)。两种治疗方案的临床疗效相比较,观察组中胃肠减压﹑胃肠功能恢复﹑血淀粉酶恢复正常和平均住院时间均小于对照组,且有统计学意义(P<0.05),而体温恢复正常时间差异无统计学意义(P>0.05)。结论:对于SAP患者,相比单纯常规治疗,联合应用早期EN和柴芍承气汤,可以尽快改善患者临床症状,缩短住院时间。

Objective： To investigate the clinical efficacy of combined early enteral nutrition and Chaishao Chengqi decoction in treating severe acute pancreatitis（SAP）. Methods： 42 patients with severe acute pancreatitis were retrospectively divided into trial group and control group according to different treatment methods. Results： There were no significant differences in white blood cells（WBC）, blood glucose, blood amylase, urine amylase, C-reactive protein（CRP） and PCT between trial group and control group before treatment（P 〉0.05）; these six indices after treatment was significantly lower than before（P〈0.05） in both groups. There were no differences in WBC, blood glucose and PCT before and after treatment in two groups（P 〉0.05）, but blood amylase, urine amylase and CRP had significantl differences（P〈0.05）. The clinical efficacy, the time of gastrointestinal decompression, gastrointestinal function, blood amylase and average hospital stay of the trial group were all less than those of the control group, and there was statistical significance（P〈0.05）. But the recovery time of body temperature in two groups had no statistical significance（P 〉0.05）. Conclusion： The therapy of early enteral nutrition combined with chaishao chengqi decoction can improve clinical symptoms and shorten hospital stay than simple routine therapy for SAP.