清热通腑化瘀颗粒灌肠治疗急性胰腺炎30例

Clinical effect of enema with Qingre Tongfu Huayu Granule in treatment of acute pancreatitis:An analysis of 30 cases

目的:基于急下存阴理论,探讨清热通腑化瘀颗粒灌肠治疗急性胰腺炎(AP)的临床疗效。方法:收集60例AP患者,将其随机分为2组,每组各30例,对照组采用西医常规治疗,治疗组在对照组基础上加用清热通腑化瘀颗粒灌肠治疗,疗程均为7 d。比较2组禁食时间、腹痛和腹胀缓解时间、住院时间、胃肠功能恢复时间(包括肠鸣音恢复、首次排气和排便、进食恢复)以及胰周炎症吸收时间,和2组治疗前后白细胞(WBC)、C反应蛋白(CRP)、血淀粉酶、血脂肪酶的水平变化,并评定综合疗效。结果:总有效率治疗组为86.67%(26/30),对照组为63.33%(19/30),2组比较,差异有统计学意义(P<0.05)。治疗组在禁食时间、腹痛和腹胀缓解时间、住院时间、胃肠功能恢复时间以及胰周炎症吸收时间方面均优于对照组(P<0.05);2组WBC、CRP、血淀粉酶和血脂肪酶水平治疗后均较治疗前降低,且治疗组优于对照组(P<0.05)。结论:清热通腑化瘀颗粒灌肠可显著促进AP患者胃肠功能的恢复,有效改善临床症状,提高临床疗效。

Objective:To investigate the clinical effect of enema with Qingre Tongfu Huayu Granule in the treatment of acute pancreatitis(AP)based on the theory of timely purgation to preserve Yin.Methods:A total of 60 patients with AP were selected and randomly divided into treatment group and control group,with 30 patients in each group.The patients in the control group were given conventional Western medicine treatment,while those in the treatment group were given enema with Qingre Tongfu Huayu Granule in addition to the treatment in the control group,and the course of treatment was 7 days for both groups.The two groups were compared in terms of fasting time,time to alleviation of abdominal pain and abdominal distension,length of hospital stay,time to recovery of gastrointestinal function(recovery of bowel sound,first passing of flatus and defecation,and recovery of eating),time to absorption of peripancreatic inflammation,and changes in the levels of white blood cell count(WBC),C-reactive protein(CRP),blood amylase,and blood lipase after treatment,and overall response was assessed.Results:There was a significant difference in overall response rate between the treatment group and the control group[86.67%(26/30)vs 63.33%(19/30),P<0.05].Compared with the control group,the treatment group had significantly better results in fasting time,time to alleviation of abdominal pain and abdominal distension,length of hospital stay,time to recovery of gastrointestinal function,and time to absorption of peripancreatic inflammation(P<0.05).Both groups had significant reductions in the levels of WBC,CRP,blood amylase,and blood lipase after treatment,and the treatment group had significantly better improvements than the control group(P<0.05).Conclusion:For patients with AP,enema with Qingre Tongfu Huayu Granule can significantly promote the recovery of gastrointestinal function and effectively improve clinical symptoms and clinical outcome.