大柴胡汤合大承气汤治疗急性胰腺炎的疗效观察

Effects of of Dachaihu decoction combined with Dachengqi decoction on acute pancreatitis

目的:探讨大柴胡汤合大承气汤治疗急性胰腺炎的临床疗效。方法:选择2016年1月-2019年3月我院收治的轻中度急性胰腺炎患者96例,随机分为对照组和治疗组,每组48例。对照组给予常规治疗,治疗组在对照组的基础上加用大柴胡汤合大承气汤内服治疗。比较两组的总有效率、中医证候积分、APACHEⅡ评分、症状改善和胃肠功能恢复时间、血淀粉酶(AMS)、尿淀粉酶(UAMY)、脂肪酶(LPS)、C反应蛋白(CRP)、白细胞计数(WBC)、降钙素原(PCT)、白细胞介素-1β(IL-1β)。结果:治疗组的总有效率明显高于对照组(P<0.05);与治疗前比较,对照组和治疗组的中医证候积分、APACHEⅡ评分均降低,且治疗组低于对照组;治疗组腹胀、腹痛、发热等症状缓解时间、住院时间和肛门排气、排便等胃肠功能恢复时间均低于对照组;与治疗前比较,两组AMS、UAMY、LPS、CRP、WBC、PCT、IL-1β均降低,且治疗组低于对照组。结论:大柴胡汤合大承气汤治疗急性胰腺炎可以提高临床疗效,改善症状,促进胃肠功能恢复,抑制炎症因子的表达。

Objective:To study the effects of Dachaihu decoction combined with Dachengqi decoction in the treatment of acute pancre-atitis.Methods:Ninety-six patients with mild to moderate acute pancreatitis admitted to our hospital from January 2016 to March 2019 were randomly divided into control group and treatment group,with 48 cases in each group.The control group received routine treat-ment,and the treatment group received Dachaihu decoction combined with Dachengqi decoction on the basis of the control group.The total effective rate,TCM syndrome score,APACHE II score,symptom improvement and gastrointestinal function recovery time,blood amylase(AMS),urinary amylase(UAMY),lipase(LPS),C-reactive protein(CRP),white blood cell count(WBC),procalcitonin(PCT),interleukin-1β(IL-1β)were compared.Results:After treatment,the total effective rate of the treatment group was significantly higher than that of the control group(P<0.05).Compared with the treatment group,the TCM syndrome scores and APACHE II scores of the control group and the treatment group were lower than before treatment,and the treatment was lower than the control group.The time of abdominal distension,abdominal pain,fever and other symptom relief time,hospitalization time,and the recovery time of gastroin-testinal function were lower than that of the control group;Compared with the two groups of AMS,UAMY,LPS,CRP,WBC,PCT,IL-1βwere all lower than before treatment,and the treatment group was lower than the control group.Conclusion:Dachaihu decoction combined with Dachengqi decoction can improve clinical curative effect,improve symptoms,promote gastrointestinal function recovery and inhibit the expression of inflammatory factors.