早期两路补液联合大黄芒硝散治疗急性胰腺炎临床观察及作用机制

The Clinical Observation and Mechanism of Early Two Way Rehydration Combined with Rhubarb and Mirabilite Powder in the Treatment of Acute Pancreatitis

目的研究早期两路补液联合大黄芒硝散治疗急性胰腺炎的临床疗效及作用机制。方法研究采用随机单盲对照法收集60例病例,并根据住院的先后顺序随机分为2组,每组30例。所有患者住院后予常规西药治疗。对照组采用两路补液,一路为常规西药输液治疗,另一路为生理盐水补液治疗,补液总量按3 mL/(kg·h)计算,24 h后保留一路常规西药输液治疗。试验组在对照组基础上予大黄芒硝散外敷腹部1周。2组给予相应治疗后观察临床疗效及测定血清CRP、IL-6水平。结果试验组与对照组早期液体复苏达标率分别为96.67%、93.33%,差异无统计学意义(P>0.05);试验组临床疗效优于对照组(P<0.05);试验组CRP下降程度显著优于对照组(P<0.01),且IL-6下降程度优于对照组(P<0.05)。结论早期两路补液联合大黄芒硝散外敷腹部治疗急性胰腺炎疗效显著,其机制可能与降低患者血清CRP、IL-6水平,减轻炎症反应有关。

Objective To observe the clinical efficacy of early two ways rehydration combined with rhubarb and mirabilite powder in the treatment of acute pancreatitis and explore its mechanism.Methods Study by random single blind control method to collect 60 cases,according to the order of hospitalization,the collected cases were randomized into two groups,each group had 30 cases.All patients were given conventional western medicine after hospitalization.The control group was treated with two way rehydration,one way with conventional western medicine infusion,and the other way with physiological saline infusion.The total amount of fluid infusion was calculated as 3ml/(kg h),and keep one way with conventional western medicine infusion treatment after 24 hours.The test group was treated with rhubarb and mirabilite powder for external application of the abdomen for 1 weeks on the basis of the control group.The clinical effect was observed and the levels of serum CRP and IL-6 were measured after the corresponding treatment in the two groups.Results The test group and the control group of early fluid resuscitation compliance rate was 96.67%,compared to 93.33%,there was no significant difference between them(P>0.05).The clinical efficacy of the test group was better than that of the control group(P<0.05).The decrease of CRP in the test group was significantly better than that in the control group(P<0.01).The decrease of IL-6 in the test group was significantly better than that in the control group(P<0.05).Conclusion Early two ways rehydration combined with rhubarb and mirabilite powder for external application of the abdomen has good clinical therapeutic efficacy in the treatment of patients with acute pancreatitis.Its mechanism is to reduce the levels of serum CRP and IL-6.