健脾通腑方序贯治疗急性轻中度胰腺炎的临床观察

Clinical Observation of Sequential Therapy with Jianpi Tongfu Formula for Acute Pancreatitis at the Mild and Middle Stage

目的观察健脾通腑方序贯治疗急性轻中度胰腺炎的临床疗效。方法将96例急性轻中度胰腺炎的患者分为治疗组(其中使用中药灌肠+口服组35例,单纯中药口服组23例)58例,和对照组38例。对照组给以常规西医治疗。治疗组包括中药灌肠+口服组及单用中药口服组,中药灌肠+口服组在西医治疗基础上,给予健脾通腑方辨证加减,根据是否开放饮食,未开放饮食的给予中药汤剂200 ml保留灌肠,2次/d,开放饮食后换用中药汤剂温服,200 ml/次,3次/d;单纯中药口服组,在开放饮食后给予中药汤剂温服,200 ml/次,3次/d。治疗10 d后,观察比较两组患者症状体征、血尿淀粉酶、血常规、腹痛缓解时间、恢复饮食时间、C反应蛋白、尿胰蛋白酶原和住院天数。结果治疗后治疗组总有效率为96.6%,对照组总有效率为84.2%,两组比较,差异有统计学意义(P<0.05);治疗后治疗组患者腹痛缓解时间、恢复饮食时间、C反应蛋白恢复时间及住院天数均较对照组明显减少,两组比较,差异有统计学意义(P<0.05)。且治疗组中中药灌肠+口服组患者恢复饮食时间、C反应蛋白恢复时间均较中药口服组明显减少,两组比较,差异有统计学意义(P<0.05)。结论健脾通腑方能够改善急性胰腺炎的疗效,且序贯治疗效果更好。

Objective To observe the clinical therapeutic effect of sequential therapy with jianpi tongfu formula in the treatment of acute pancreatitis at mild and middle stage. Methods Ninety-sixe patients of acute pancreatitis at mild and middle stage were divided into a treatment group,58 cases,in which35 cases in Chinese medicine enema plus oral administration group and 23 cases in simple Chinese medicine oral administration group; and a control group,38 cases,in which the conventional western medicine treatment was applied. In the treatment group,two subgroups were divided,named the Chinese medicine enema plus oral administration group and the simple Chinese medicine oral administration group. In the Chinese medicine enema plus oral administration group,on the basis of western medicine,the jianpi tongfu formula was modified according to the syndrome/pattern differentiation. Before diet recovery time,the enema with Chinese herbal decoction 200 ml was used,twice a day. After diet recovery time,the oral administration of Chinese herbal decoction was used,200 ml each time,three times a day. In the simple Chinese medicine oral administration group,Chinese herbal decoction was used,200 ml each time,three times a day. In 10 days of treatment,the symptoms,physical signs,amylase in blood and urine,blood routine,the relief time of abdominal pain,the recovery time of regular diet,C-reactive protein,urinary trypsinogen and hospital stay were observed and compared in the two groups. Results After treatment,the total effective rate was 96. 6% in the treatment group and was 84. 2% in the control group,indicating the significant difference in comparison of the two groups（P〈0. 05）. After treatment,the relief time of abdominal pain,the recovery time of regular diet,the recovery time of C-reactive protein and hospital stay in the treatment group were reduced apparently as compared with those in the control group. The differences were significant in comparison of the two groups（P〈0. 05）.In the Chinese medicine enema plus oral administration group,the recovery time of regular diet and the recovery time of C-reactive protein was reduced apparently as compared with those in the simple Chinese Chinese medicine oral administration group,indicating the significant difference（P〈0. 05）. Conclusion The jianpi tongfu formula improves the therapeutic effect on acute pancreatitis and the sequential treatment achieves the much better effect.