清胰利胆合剂灌肠预防ERCP术后胰腺炎和高淀粉酶血症的临床研究

Clinical study on Qingyi Lidan Mixture Enema(清胰利胆合剂) in the Preventive of Post ERCP Pancreatitis and Hyperamylasemiato

目的:观察清胰利胆合剂灌肠对内镜下逆行胰胆管造影(ERCP)术后胰腺炎(post-ERCP pancreatitis,PEP)和高淀粉酶血症(post-ERCP hyperamylasemia,PEH)的预防作用,评价其有效性及安全性。方法:将60例预行ERCP术的患者随机分为治疗组(31例)和对照组(29例)。两组患者术前均常规治疗,治疗组患者术前2 h给予清胰利胆合剂100 mL保留灌肠,对照组患者术前2 h给予吲哚美辛栓0.1 g塞肛。记录PEP和PEH发生例数,观察两组患者术前及术后4 h、24 h的血淀粉酶、C反应蛋白(CRP)、降钙素(PCT)原变化情况,观察患者术后腹痛症状。结果:两组患者PEP和PEH发生率、术后腹痛评分比较,差异均无统计学意义(P>0.05);治疗组患者在术后24 h血淀粉酶水平低于对照组,差异有统计学意义(P<0.05)。结论:清胰利胆合剂预防PEP及PEH与对照药物吲哚美辛的疗效相当,能降低PEP及PEH的发生率,缓解术后腹痛程度,减轻机体炎症反应。

Objective:To observe the preventive effect of Qingyi Lidan mixture enema on of post ERCP pancreatitis and hyperamylasemiatoand and to evaluate its efficacy and safety.Methods:60 cases were randomly divided into two groups group:the Chinese medicine group(n=31)and the western medicine group(n=29).Routine treatment before operation in both groups,the traditional Chinese medicine group was treated with Qingyi Lidan mixture 100 mL retention enema 2 hours before ERCP,western medicine group treated with 0.1 g indomethacin suppository 2 hours before operation.Record the incidence of PEP and PEH,and the changes of serum amylase,CRP and procalcitonin beforeoperation,4 hours after operation and 24 hours after operation,and symptoms of abdominal pain,and statistical analysis.Results:There was no significant difference in the incidence of PEP and PEH between the traditional Chinese medicine group and the western medicine group,the difference of abdominal pain score before and after ERCP,and inflammatory response control(P>0.05).The serum amylase level in the Chinese medicine group was significantly lower than that in the western medicine group at 24 hours after operation(P<0.05).Conclusion:The efficacy of traditional Chinese medicine in the prevention of PEP and PEH is similar to that of the control drug indomethacin,it can reduce the incidence of PEP and PEH,relieve abdominal pain,and alleviate the inflammatory reaction.