清胰化积汤结合理气膏穴位贴敷疗法治疗急性胰腺炎临床疗效

Clinical Efficacy and Safety of Qingyi Huayi Decoction(清胰化积汤)Combined with Liqi Plaster(理气膏)Therapy for Acute Pancreatitis

目的 研究急性胰腺炎采取清胰化积汤与理气膏穴位贴敷治疗价值。方法 纳入109例急性胰腺炎患者(2017年7月—2020年1月),将其分成对照组(54例)与观察组(55例),对照组患者采取奥曲肽、加贝酯、奥美拉唑等西药常规治疗,观察组患者采取奥曲肽、加贝酯、奥美拉唑等西药常规治疗+理气膏穴位贴敷及清胰化积汤治疗,比较各组患者治疗效果及治疗前后中医症状(口苦咽干、腹痛及嗳气呕恶、胸胁苦满、舌淡红、苔薄白等)积分变化、患者腹痛腹胀、发热呕吐等症状改善时间、患者心电监护时间、住院时间、治疗后1 d、7 d患者肠鸣音评分变化、治疗前后患者胃肠功能评分、急性生理与慢性健康评分(APACHE-II)、C反应蛋白(CRP)水平变化、血淀粉酶指标变化与不良反应。结果 观察组总有效率96.36%(53/55)与对照组83.33%(45/54)相比更高,P<0.05;观察组患者腹痛腹胀、发热呕吐等症状改善时间、患者心电监护时间、住院时间均短于对照组,P<0.05;治疗前,两组患者腹痛、口苦咽干、嗳气呕恶、胸胁苦满、舌淡红、苔薄白等中医症状积分、胃肠功能评分、 APACHE-II评分、血淀粉酶指标、CRP比较,P>0.05,各组患者治疗后口苦咽干、腹痛及嗳气呕恶、胸胁苦满、舌淡红、苔薄白等中医症状积分、胃肠功能评分、 APACHE-II评分、CRP水平及血淀粉酶水平均改善,观察组患者治疗后腹痛、口苦咽干、嗳气呕恶、胸胁苦满、舌淡红、苔薄白等中医症状积分、胃肠功能评分、 APACHE-II评分、CRP水平及血淀粉酶水平优于对照组,P<0.05;治疗后1d两组患者肠鸣音评分相近,P>0.05,治疗7d后各组肠鸣音评分降低,观察组低于对照组,P<0.05;观察组治疗出现1例乏力,对照组出现1例头晕,1例头痛,P>0.05。结论 理气膏穴位贴敷与清胰化积汤结合治疗急性胰腺炎效果佳,安全可靠。

Objective To study the therapeutic value of Qingyi Huayi Decoction(清胰化积汤)and Liqi Plaster(理气膏)on acute pancreatitis.Methods A total of 109 patients with acute pancreatitisfrom July 2017 to January 2020 were enrolled and divided into control group(54 cases)and observation group(55 cases).Patients in the control group received conventional treatment with octreotide,gabetil,omeprazole and other western medicine.The observation group was treated with octreotide,gabeate,omeprazole and other western medicine conventional treatment+acupoint application of Liqi Plaster and Qingyi Huaji Decoction.The treatment effect of the patients in each group and the changes in the scores of TCM symptoms before and after treatment(bitter mouth,dry throat,abdominal pain,belching and vomiting,full chest pain,pale red tongue,thin and white fur,etc.),the improvement time of symptoms such as abdominal pain,abdominal distension,fever and vomiting,the ECG monitoring time of the patients,the hospitalization time,the changes in the score of bowel sounds of the patients on the 1 st and 7 th day after treatment,the gastrointestinal function score of the patients before and after treatment,the acute physiology and chronic health score(APACHE-II),C-reactive protein(CRP),blood amylase index and adverse reactions were compared.Results Compared with that(83.33%,45/54)of the control group,the total effective rate(98.15%,53/55)of the observation groupwas higher(P<0.05).The improvement time of abdominal pain,abdominal distension,fever and vomiting,the time of ECG monitoring and the length of hospital stay in the observation group were all shorter than those in the control group(P<0.05).Before treatment,comparison of TCM symptom scores,such as gastrointestinal function score,abdominal pain,bitter mouth and dry throat,belching and vomiting,full chest and flank pain,pale tongue and thin and white fur,APACHE-II score,blood amylase index and CRP between the two groups were not significant(P>0.05).After treatment,the TCM symptom scores,APACHE-II score,CRP level and blood amylase level were all improved in each group.The improvement in the observation group was better than that of the control group(P<0.05).On the 1 st day after treatment,the scores of bowel sounds in the two groups were similar(P>0.05).On the 7 th day after treatment,the scores of bowel sounds in the observation group were lower than those in the control group(P<0.05).In the observation group,there was 1 case of fatigue,and in the control group,there was 1 case of dizziness and 1 case of headache(P>0.05).Conclusion Liqi Plaster combined with Qingyi Huaji Decoction in the treatment of acute pancreatitis is effective,safe and reliable.