清胰利胆汤联合西医疗法治疗急性胆源性胰腺炎临床观察

Clinical Observation of Qingyi Lidan Tang Combined with Western Medicine Therapy for ABP

目的:观察清胰利胆汤联合西医疗法治疗急性胆源性胰腺炎的临床效果。方法:选取120例湿热内蕴型急性胆源性胰腺炎患者作为研究对象,并按随机数字表法分为治疗组与对照组各60例,对照组给予常规治疗方案,治疗组在对照组治疗基础上加用清胰利胆汤治疗,比较2组患者中医证候评分、胰腺影像学形态及实验室指标[谷丙转氨酶(ALT)、碱性磷酸酶(ALP)、血淀粉酶(AMY)及尿淀粉酶(UAMY)]的改善情况。结果:治疗后,治疗组总有效率(91.67%)高于对照组(68.33%),2组比较,差异有统计学意义(P<0.05)。2组腹痛、上腹压痛感、腹胀、发热、恶心呕吐、嗳气、小便短赤、身目黄染评分较治疗前均有降低(P<0.05),治疗组各项评分均低于对照组(P<0.05)。2组CT影像学形态分级较治疗前均有改善(P<0.05),但2组间比较,差异无统计学意义(P>0.05)。2组ALP、ALT、AMY、UAMY水平较治疗前均降低(P<0.05),治疗组各项实验室指标值均低于对照组(P<0.05)。结论:在常规西药保守治疗基础上加用清胰利胆汤疏肝利胆、通腑泄热,可有效缓解湿热内蕴型急性胆源性胰腺炎患者的临床症状,改善胰腺影像学形态,更快地降低血、尿淀粉酶水平,临床疗效显著。

Objective： To observe the clinical effect of Qingyi Lidan tang combined with western medicine therapy for acute biliary pancreatitis （ABP）. Methods. Selected 120 ABP patients with syndromes of damp-heat retention as study object, and divided them into the treatment group and the control group being 60 cases in each according to the random table method. The control group was given routine treatment, while the treatment group was given Qingyi Lidan tang based on the treatment of the control group. Compared improvement of Chinese medicine syndrome score, morphology pancreatic imaging and laboratory indexes which includes alanine transaminase （ALT）, alkaline phosphatase （ALP）, blood amylase （AMY） and urine amylase （UAMY） before and after treatment. Results, After treatment, the total effective rate of the treatment group was 91.67%, being higher than the 68.33% of the control group（P 〈0.05）. Scores of abdominal pain, epigastric tenderness, abdominal distension, fever, nausea and vomiting, short and red urine, belching, yellow staining of body and eyes of the two groups were all lower than those before treatment （P 〈 0.05）, and scores of the above indexes of the treatment group were all lower than those of the control group （P 〈 0.05）. Classification of CT imaging morphology of the two groups were improved （P 〈 0.05）, difference of the two groups had no significant （P〉 0.05）. Levels of ALP, ALT, AMY and UAMY of the two groups were lower than those before treatment （P〈 0.05）, values of the above laboratory indexes of the treatment group were all lower than those of the control group （P 〈 0.05）. Conclusion： Based on routine treatment of western medicine, the application of Qingyi Lidan tang which is able to disperses stagnated liver qi to promote bile flow and purges fu-organs to eliminate heat can relieve clinical symptoms of patient with ABP, improve morphology pancreatic imaging, reduce levels of AMY and UAMY, has significant clinical effect.