厚朴排气合剂联合早期肠内营养治疗重症急性胰腺炎的疗效观察

Therapeutic effect of Houpu exhaust mixture combined with early enteral nutrition on severe acute pancreatitis

目的探讨厚朴排气合剂联合早期肠内营养治疗重症急性胰腺炎(SAP)患者的疗效和安全性。方法将2017年1月至2022年10月空军军医大学西京医院重症医学科收治的108例SAP患者作为研究对象,经筛选,纳入本研究58例。回顾性分析常规治疗SAP基础上给予早期肠内营养的治疗方案(对照组,n=33)以及常规治疗SAP基础上给予厚朴排气合剂联合早期肠内营养的治疗方案(治疗组,n=25)的疗效。观察两组患者肠鸣音恢复时间、第一次排便时间、连续肾脏替代治疗(CRRT)时间、机械通气时间、ICU住院时间,以及治疗第3日腹腔压力、胃肠功能障碍评分、急性生理与慢性健康评分系统Ⅱ(APACHEⅡ)评分。结果治疗组肠鸣音恢复时间、第一次排便时间、ICU住院时间较对照组缩短(P<0.05),两组间CRRT时间、机械通气时间比较差异无统计学意义(P>0.05)。与对照组相比,治疗组第3日腹腔压力、胃肠功能障碍评分、APACHEⅡ评分更低(P<0.05)。结论厚朴排气合剂联合早期肠内营养治疗可改善SAP患者胃肠功能,降低疾病严重程度,提高救治疗效。

Objective To study the effect and safety of Houpu exhaust mixture combined with early enteral nutrition on severe acute pancreatitis(SAP).Methods A total of 108 SAP patients admitted to Department of Critical Care Medicine,Xijing Hospital,Air Force Medical University from January 2017 to October 2022 were selected as subjects,and 58 patients were included in this study after screening.Retrospective analysis was performed on the therapeutic effects of the treatment regimen of early enteral nutrition based on conventional treatment of SAP(control group,n=33)and the treatment regimen of Houpu exhaust mixture combined with early enteral nutrition based on conventional treatment of SAP(treatment group,n=25).The time to bowel sound recovery,first bowel movement,continuous renal replacement therapy(CRRT),mechanical ventilation and ICU stay,and abdominal pressure,gastrointestinal dysfunction score and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score on the 3rd day of treatment were observed in the two groups.Results The time to bowel sound recovery,first bowel movement,and ICU stay in the treatment group were shorter than those in the control group(P<0.05),but there was no significant difference in CRRT time and mechanical ventilation time between the two groups(P>0.05).Compared with the control group,abdominal pressure,gastrointestinal dysfunction score and APACHEⅡscore on the 3rd day of treatment were lower in the treatment group(P<0.05).Conclusion Houpu exhaust mixture combined with early enteral nutrition can improve the gastrointestinal function,reduce the severity of the disease,and improve the therapeutic effect of SAP patients.