加味大承气汤与芒硝交替外敷治疗急性胰腺炎疗效分析及护理体会

Clinical Analysis and Nursing Thoughts on Modified Dachengqi Tang Combined with Alternate External Application with Mirabilite for Acute Pancreatitis

目的:观察加味大承气汤与芒硝交替外敷治疗急性胰腺炎(AP)的疗效及护理体会。方法:将106例AP患者按随机数字表法分为对照组和观察组各53例。2组均给予内科治疗,对照组加用芒硝外敷于胰腺体表投影区和脐周,观察组采用加味大承气汤与芒硝交替外敷,连续治疗5~10天。对比分析2组临床疗效,记录腹胀、腹痛评分和相关临床指标的恢复时间。结果:经秩和检验,观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗2天、5天和10天,2组腹胀及腹痛评分均较治疗前下降(P<0.01);观察组腹痛评分均低于同期对照组(P<0.01)。治疗5天和10天,观察组腹胀评分均低于同期对照组(P<0.01)。观察组腹胀、腹痛缓解时间,肠鸣音恢复时间,首次排气时间,胰腺酶学恢复时间及住院时间均短于对照组(P<0.01)。结论:加味大承气汤与芒硝交替外敷治疗AP,可以改善患者腹痛、腹胀等临床症状,促进胃肠功能恢复,值得推广使用。

Objective:To observe the clinical effect and nursing thoughts of modified Dachengqi tang combined with alternate external application with mirabilite for acute pancreatitis(AP).Methods:Divided 106 cases of patients with AP into the control group and the observation group randomly,53 cases in each group.Both groups received the internal medical treatment;the control group additionally received the external application with mirabilite in the surface projection area of pancreas and periumbilically,while the observation group received modified Dachengqi tang combined with alternate external application with mirabilite.The treatment of both groups lasted for 5 to 10 days continuously.Compared and analyzed the clinical effect in both groups,and recorded the scores of abdominal pain and distension and the recovery time of relevant indexes.Results:By means of rank sum test,the clinical effect in the observation group was better than that in the control group,difference being significant(P<0.05).After 2 days,5 days and 10 days of treatment,the scores of abdominal pain and distension in both groups were lower than those before treatment(P<0.01);the scores of abdominal pain in the observation group were lower than those in the control group in the same period(P<0.01).After 5 days and 10 days of treatment,the scores of abdominal distension in the observation group were lower than those in the control group in the same period(P<0.01).The release time of abdominal pain and distension,the recovery time of borborygmi,the time of first exsufflation,the recovery time of pancreatic enzymes and the hospitalization time in the observation group were respectively shorter than those in the control group(P<0.01).Conclusion:Modified Dachengqi tang combined with alternate external application with mirabilite for AP can improve such clinical symptoms as abdominal pain and distension and promote the recovery of gastrointestinal function,which is worthy of clinical promotion and application.