清胰汤合大承气汤联合西药治疗老年急性胰腺炎64例临床观察

Qingyitang co Dachengqitang Elderly Patients with Acute Pancreatitis combined with Western Observation of 64 Cases

[目的]观察清胰汤合大承气汤联合西药治疗老年急性胰腺炎疗效。[方法]使用前瞻性设计方法,64例住院患者禁食、持续胃肠减压、补充输液、纠正电解质及酸碱平衡、维持循环稳定;抗生素、营养支持及内外分泌功能替代治疗;奥美拉唑,40mg/次,2次/d。清胰汤合大承气汤(黄芩12g,元胡10g,大黄后下15g,白芍、木香各10g,柴胡12g,丹皮、厚朴各10g;热重加黄连、黄芩;湿热重加白头翁、秦皮、葛根;腑气不通伴痞满燥实重加厚朴、枳壳;气滞加柴胡、郁金、青皮、香附;血瘀加当归、川芎、鸡血藤;热入营血加丹皮、生地、连翘、玄参;食积加厚朴、山楂、麦芽、神曲),1剂/d,水煎200m L,胃管注入,8h/次,夹管2h;腹胀明显予该方200m L保留灌肠,30min/次,1次/d。连续治疗14d为1疗程。观测临床症状、便常规、不良反应。治疗1疗程,判定疗效。[结果]痊愈42例,显效12例,有效6例,无效3例,死亡1例,总有效率93.75%。[结论]清胰汤合大承气汤联合西药治疗老年急性胰腺炎疗效满意,无严重不良反应,值得推广。

[Objective]To observe Qingyitang co Daehengqitang combined with Western treatment of elderly acute effect.[Methods]Using a prospective design methods,64 cases of hospitalized patients with early antibiotic,nutritional support and external secretory function replacement therapy;fasting,continuous gastrointestinal decompression,add infusion,correction of electrolyte and acid-base balance and maintain stable circulation;Austria omeprazole,40mg/times,2 times/d.Qingyitang co Dachengqitang（Huangqi 12g,Yuanhu 10g,Dahuang 15g,Baishao,Muxiang 10g,Chaihu 12g,Danpi,Houpu each 10g;TGA plus Huanglian,Huangqi;re- heat plus Baitouwong,Qinpi,Gegen;bowel gas barrier with fullness dry solid weight plus Houpu,Zhike;qi stagnation plus Chaihu,Yujin,Qingpi,Xiangfu;blood stasis plus Dangui,Chuanxiong,Jixueteng;heat into Camp Blood Jia Dan pi,Shengdi,Lianqiao,Xuanshen;food product plus Houpu,Shanzha,Maiya,Shenqu）,a/d,deeoction 200mL,injeeted into the stomach,Sh/second,pinch 2h;abdominal distension to The party 200mL enema,3Omin/times,1 times/d.14d for a course of continuous treatment.Observation of clinical symptoms,then routine,adverse reactions.One course of treatment,to determine efficacy.[Results]Recovered 42 cases,12 cases markedly effective in 6 cases,3 cases,1 death,the total efficiency of 93.75%.[ConclusionJQingyitang co Dachengqitang combined with western treatment of elderly patients with acute pancreatitis results were satisfactory,no side effects,worthy of promotion.