甘遂、大黄辅助治疗重症急性胰腺炎的临床疗效研究

A Comparative Study on the Auxiliary Therapeutic Effect of Rhubarb and Kansui Root on Patients with Severe Acute Pancreatitis

目的对比研究甘遂和大黄辅助治疗重症急性胰腺炎的作用。方法将 5 9例重症急性胰腺炎病人随机分为对照组、大黄组和甘遂组 ,分别观察用药后 3组病人的腹痛、腹部压痛及肌紧张缓解时间 ,肝、肾功能及心电图的改变 ,血、尿淀粉酶恢复时间 ,血清肿瘤坏死因子 α(TNF α)浓度的变化 ,平均住院日及病死率。结果甘遂组病人腹部症状、体征的缓解时间和血、尿淀粉酶恢复时间及平均住院日较对照组和大黄组显著减少 (P <0 .0 1 ,P <0 .0 5 ) ,甘遂组治疗 1周后血清TNF α浓度、胰腺和胰周感染的发生率明显低于对照组 (P <0 .0 5 ) ,但与大黄组比较无明显差异。结论中药甘遂是西医治疗重症急性胰腺炎有效而可靠的辅助性治疗用药 。

?Objective To make a comparative study on the auxiliary therapeutic effect of Rhubarb and Kansui root on patients with severe acute pancreatitis.Methods 59 cases with severe acute pancreatitis were randomly divided into 3 groups,i.e. controlling group,Rhubarb treating one and Kansui root treating one. Then, careful observation was made on the lasting duration of abdominal pain,tenderness and guarding,changing of hyperamylasemia and hyperamylasuria, total days of hospitalization and the level of TNF α for all cases among the three groups until the end of one week therapy. At last,the incidence of pancreatic abscess and the mortality of it were analysed among all the groups.Results The lasting duration of abdominal pain,tenderness and guarding, hyperamylasemia and hyperamylasuria was significantly shorted,the mean days of hospitalization were largely reduced, and the level of TNF α by the end of one week therapy and the incidence of pancreatic abscess after the therapy were decrased largely in the group treated by Kansui root.However,there was no significant difference seen in the mortality when compared among the groups (P>0.05).Conclusion Kansui root is effective and safe for the treatment of patient with severe acute pancreatitis as an auxillary therapeutic material medica, with better outcome than Rhubarb. 〔