中西医结合治疗重症急性胰腺炎生长抑素应用的临床研究

Clinical Study on Treatment of Severe Acute Pancreatitis by Integrative Chinese and Western Medicine Combined with Somatostatin

目的 :探讨在现有中西医结合治疗重症急性胰腺炎基础上 ,早期短疗程联合应用生长抑素 ,能否进一步提高疗效。方法 :将 6 0例重症急性胰腺炎患者随机分为生长抑素组 (30例 )和基础治疗组 (30例 )。两组均给予中西医结合非手术治疗 ,生长抑素组另加用生长抑素以 2 5 0 μg/h连续用唯泵静脉泵入持续 72h。比较两组多项实验室指标、病情程度、脏器功能衰竭发生率、局部并发症发生率和病死率等疗效指标。结果 :生长抑素组血淀粉酶、血脂肪酶、C反应蛋白 (CRP)、乳酸脱氢酶 (LDH)、门冬氨酸氨基转移酶 (AST)、急性生理和慢性健康状况评分 (APACHEⅡ )等的恢复优于基础治疗组 (P <0 0 5 )。生长抑素组局部并发症和脏器衰竭发生率低于基础治疗组 ,但差异无显著性。两组病死率差异无显著性。结论 :中西医结合联合早期短疗程应用生长抑素可改善重症急性胰腺炎的病情 ,对病死率的影响尚需扩大样本进一步研究。

Objective: To study whether the therapeutic effect could be enhanced by combined use of somatostatin and conventional integrative Chinese and western medicine (TCM-WM) in treating severe acute pancreatitis (SAP). Methods: Sixty patients of SAP were randomly divided equally into the somatostatin group (Group A) and the baseline treated group (Group B), they were all treated with non-surgical TCM-WM treatment, but to Group A, the intravenous injection of somatostatin 250 μg/h for 72 hrs continuously was given additionally. Laboratory parameters, condition of disease and therapeutic effect indexes, including occurrence of organic dysfunction, local complication and mortality, between the two groups were compared. Results: The recovery of serum levels of amylase, lipase, C reaction protein, lactate dehydrogenase, aspartate aminotransferase, as well as the scores of APACHE Ⅱ in Group A were quicker than those in Group B (P<0 05). The occurrence of organic dysfunction and local complication in Group A were lower to those in Group B, but without statistic significance. Comparison of the mortality in the two groups showed insignificant difference (P>0 05). Conclusion: The early stage short course of combined TCM-WM and somatostatin treatment could improve the condition of SAP, but its effect on mortality should be further verified by enlarging the sample size.