【www.zhangdahai.com--经济论文】
[摘要] 目的:研究柴芩承气汤治疗急性重症胰腺炎(ASP)的作用。方法:急性重症胰腺炎患者33例(男21例,女12例),按治疗方案分为中西医结合治疗组(23例)和单纯西医治疗组(10例)。中西医结合治疗组在传统西医治疗方案的基础上加用中药柴芩承气汤。结果:33例患者均治愈出院,但在住院时间、治疗费用、连续睡眠时间长短以及自主排便天数方面,中西医结合治疗组明显优于单纯西医治疗组,在镇痛药物使用上,中西医结合治疗组的应用剂量明显低于单纯西医治疗组。结论:柴芩承气汤在治疗急性重症胰腺炎的治疗中作用显著,中西医结合治疗优势明显。
[关键词] 柴芩承气汤;急性重症胰腺炎;中西医结合
[中图分类号] R576 [文献标识码]A [文章编号]1674-4721(2010)06(a)-005-03
Exploratory study on the effect of Chaiqinchengqi Decoction treating acute severe pancreatitis
JIN Qi1,LI Mingzhen2,SHEN Yanxing3,HU Mingming4,HAN Zhongrong1,JIANG Bei1,HUANG Shuo2
(1. Department of Internal Medicine, the First Affiliated Hospital of Jiamusi University, Heilongjiang Province, Jiamusi 154003,China;2. Department of Surgery, the First Affiliated Hospital of Jiamusi University, Heilongjiang Province, Jiamusi 154003,China; 3. Department of Internal Medicine, Hegang Red Cross Hospital, Heilongjiang Province, Hegang 154100,China;4. Department of Internal Medicine, Shandong Province Ankang Hospital, Shandong Province, Jining 273500,China)
[Abstract] Objective: To study the effect of Chaiqinchengqi Decoction treating acute severe pancreatitis (ASP). Methods: 33 cases of ASP (male 21 cases, female 12 cases), were divided into two groups by the different therapy: group1 used clinical medicine combined with Chinese traditional medicine (23 patients), group 2 only used clinical medicine (10 patients). We chose Chaiqinchengqi Decoction as the traditional Chinese medicine. Results: 33 cases of patients were
all cured and discharge. However, the two groups were different in the duration, expense, time of continuing sleep and the time of stool. The group 1 was better than group 2. The usage of analgesic in group 1 were lower than that of group 2. Conclusion: The effect of Chaiqinchengqi Decoction is significant in treating acute severe pancreatitis (ASP). The therapy combined with Chinese traditional medicine and clinical medicine is preferred to clinical medicine.
[Key words] Chaiqinchengqi Decoction;Acute severe pancreatitis; Clinical medicine combined with Chinese traditional medicine
急性重症胰腺炎(acute severe pancreatitis, ASP)是临床常见的危急重症之一,目前认为其致病机制是胰酶对胰脏本身自身消化所引起的化学反应,急性重症胰腺炎不仅会造成胰腺的损伤,还会出现严重的并发症和全身症状,甚至危及生命[1]。由于患者病情重,治疗时间长,费用昂贵,探讨正确而有效的护理方式有重要意义。笔者总结2009年本院消化内科和普通外科对急性重症胰腺炎患者的治疗过程,现将体会报道如下:
1 资料与方法
1.1一般资料
本院2009年1～12月共收治急性重症胰腺炎患者33例,男21例,女12例;年龄22～69岁。入院时的临床表现有暴饮暴食或酗酒后剧烈腹痛、恶心、呕吐、高度腹胀、停止排气排便,患者还分别伴有高热不退、黄疸加深、意识模糊和谵妄、血压下降等。实验室检查:白细胞>15×109/L,血糖升高(空腹血糖均>11.1 mmol/L),血钙下降( 1.3 观察指标
观察记录患者的住院时间,总治疗费用,住院期间每晚连续睡眠时间(若一晚连续多次醒转,以平均值计算),24 h内镇痛药物使用次数以及入院后首次排便日期。
1.4 统计学处理
数值采用x±s表示,以t>t(31)0.05=2.04,P [6]Greer SE, Burchard KW. Acute pancreatitis and critical illness: a pancreatic tale of hypoperfusion and inflammation [J]. Chest, 2009, 136(5):1413-1419.
[7]中华医学会消化病学分会胰腺疾病学组. 中国急性胰腺炎诊治指南(草案) [J]. 中华内科杂志, 2004,43(3): 236-238.
[8]巫协宁.重症胰腺炎的规范化治疗和治疗策略[J].中华消化杂志,2001(5),21:300-302.
[9]Wang G, Sun B, Zhu H, et al. Protective effects of emodin combined with danshensu on experimental severe acute pancreatitis[J].Inflamm Res, 2009,58(suppl).
[10]Ning JW, Ji F, Luo DD,et al. Effects of emodin on cell apoptosis of intestinal mucosa and serum leptin in rats with severe acute pancreatitis[J].Journal of Chinese Integrative Medicine,2009,7(12):1167-1173.
[11]薛平,黄宗文,郭佳,等.早期应用柴芩承气汤治疗胆源性重症急性胰腺炎的临床研究[J].中西医结合学报,2005,3(4):263-266.
[12]张圣道.急性胰腺炎的临床诊断及分级标准[J].中华外科杂志,1997,35(12):773.
[13]赖少彤,金琦,邓兆斌,等. 环丙沙星 大黄治疗急性重症胰腺炎与IL-6、IL-8相关性的研究[J].中华中医药学刊,2005,23(12):2174-2175.
[14]何剑琴,王伟岸,胡品津,等. 肠易激综合征患者睡眠质量特征[J].世界华人消化杂志,2004,12(3):744-747.
[15]Carroll JK, Herrick B, Gipson T, et al. Acute pancreatitis: diagnosis, prognosis, and treatment [J]. American Family Physician, 2007, 75(10):1513-1520.
(收稿日期:2010-04-13)
