重症急性胰腺炎应用凉膈散联合乳果糖治疗对患者炎症反应的影响

Influence for inflammatory reaction and microcirculation of severe acute pancreatitis in icu by Lianggesan and lactulose

目的:探讨重症急性胰腺炎应用凉膈散联合乳果糖灌肠对其炎症反应及微循环的影响。方法:随机选取重症急性胰腺炎患者120例,将以上患者随机分为治疗组和对照组各60例,对照组采用常规西医治疗,治疗组在对照组基础上予凉膈散联合乳果糖灌肠。分别在治疗前后观察两组患者APACHEⅡ评分与Balthazar CT评分,比较两组患者治疗前后第1、3、7、10天血清淀粉酶(AMY)水平、白细胞介素-18(IL-18)变化、C反应蛋白表达,记录患者腹痛症状缓解时间、开放肠内营养时间、生命体征平稳时间、肠鸣音恢复时间及入住ICU天数。结果:与对照组相比,治疗组在腹痛症状缓解时间、开放肠内营养时间、生命体征平稳时间及ICU住院天数均缩短,且治疗组,临床综合疗效等均优于对照组(P<0.05)。结论:ICU重症急性胰腺炎应用凉膈散联合乳果糖灌肠能改善炎症反应有效减轻症状,恢复肠功能,缩短治疗病程,值得临床使用。

Objective:To investigate the effect of Lianggesan combined with lactose enema on inflammation and microcirculation in ICU patients with severe acute pancreatitis.Methods:120 patients with severe acute pancreatitis of ICU were randomly selected.The above patients were randomly divided into the treatment group and the control group,60 each.The control group was treated with conventional western medicine.The treatment group were treat with Lianggesan and lactulose base on the control group.Two groups of patients were observed before and after treatment,APACHEⅡscore and Balthazar CT score,compared two groups of patients before and after treatment 1,3,7,10 d level of serum amylase(AMY),interleukin-18(IL-18)change,c-reactive protein expression,compared two groups of patients with abdominal pain remission time,open enteral nutrition,stable vital signs,bowel sounds recovery time and hospitalization days in the ICU.Results:Compared with the control group,the treatment group had shorter relief time for abdominal pain symptoms,enteral nutrition time,stable time for vital signs and length of stay in ICU,and better laboratory treatment and comprehensive clinical efficacy than the control group,which greatly reduced the medical expenses.Conclusion:The clinical effect of cold phrenic powder decoction combined with lactose enema can improve inflammatory reaction,effectively relieve symptoms.and restore bowel function.