中药联合莫沙必利治疗中重症急性胰腺炎并发肠麻痹的疗效观察

Therapeutic effect of Mosapride combined with traditional Chinese medicine on moderate severe acute pancreatitis complicating with intestinal paralysis

[目的]研究中药(柴芩温胆承气汤)联合莫沙必利治疗中重症急性胰腺炎并发肠麻痹的临床疗效。[方法]入选重症急性胰腺炎并发肠麻痹患者90例为研究对象,随机分为对照组与研究组各45例,对照组采用常规治疗,研究组在常规治疗基础上加用莫沙必利联合柴芩温胆承气汤口服、灌肠治疗。记录并分析2组疗效。[结果]研究组患者肠鸣音、排气排便恢复时间,腹胀、腹痛缓解时间,炎症递质、白细胞恢复正常时间,血淀粉酶恢复正常时间及住院天数均较对照组明显缩短,肠麻痹恢复有效率较对照组明显增高,Ranson评分、Balthazar CT严重指数、APACHEⅡ评分较对照组明显降低,均差异具有统计学意义(P<0.05)。[结论]柴芩温胆承气汤联合莫沙必利能有效缓解中重症急性胰腺炎患者的肠麻痹,从而防止急性胰腺炎患者病情进一步重症化,值得临床推广应用。

[Objective]To investigate the therapeutic effect of Mosapride combined with traditional Chinese medicine(Chai-qin-wen-dan-chengqi Decoction)on moderate severe acute pancreatitis(MSAP)complicating with intestinal paralysis.[Methods]A total of 90 patients with MSAP complicating with intestinal paralysis in the Department of Gastroenterology of The first people,s hospital of Kunming from August 2016 to December 2017 were enrolled in the study,which were selected and randomly divided into control group and study group,with 45 cases in each group.The control group received routine treatment,the study group was treated additionally with Mosapride plus traditional Chinese medicine(Chai-qin-wen-danchengqi Decoction)for oral and enema infusion.The relative indicators and curative effect of the two groups were observed and compared between two groups.[Results]In study group,the recovery time of bowel sound,the recovery time of restoring the anal defecation,the relief time of abdominal distension and pain,the decrease of mediators of inflammation and white blood cell,the recovery time of blood amylase and days of hospitalization were significantly shorter than the control group(P<0.05);the efficiency of healing intestinal paralysis was higher in study group(P<0.05).The score of three clinical diagnostic criteria systems[APACHE Ⅱ,Ranson and Balthazar CT severity index]were significantly lower than those in the control group(P<0.05).The difference was statistically significant(P<0.05).[Conclusion]Mosapride combined with traditional Chinese medicine(Chai-qin-wen-dan-chengqi Decoction)can effectively alleviate the intestinal paralysis of MSAP patients and avoid the deterioration of SAP,which is worthy of clinical promotion and application.