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目的 :观察大柴胡汤合薏仁败酱汤联合西医疗法治疗重症急性胰腺炎(SAP)的临床疗效。方法 :将纳入研究的68例肝胆湿热型SAP患者随机分成治疗组和对照组各34例。所有患者常规予胃肠减压、抑制胰酶分泌、抗感染等治疗,治疗组加用大柴胡汤合薏仁败酱汤治疗,2组疗程均为14天。观察2组的治疗效果、治疗前及治疗72 h后急性生理学及慢性健康状况Ⅱ(APACHEⅡ)评分及Ranson评分情况,记录2组治疗后腹胀缓解时间、肠鸣音恢复时间、首次排便时间、腹痛消失时间与血清淀粉酶、白细胞、C-反应蛋白(CRP)恢复正常的时间。结果:治疗后,治疗组痊愈率及总有效率均高于对照组,差异均有统计学意义(P<0.05)。2组APACHEⅡ评分、Ranson评分均较治疗前下降,差异均有统计学意义(P<0.05);治疗组APACHEⅡ评分、Ranson评分均低于对照组,差异均有统计学意义(P<0.05)。治疗组腹胀缓解时间、肠鸣音恢复时间、首次排便时间、腹痛消失时间与血清淀粉酶、白细胞、CRP恢复正常的时间均较对照组缩短,差异均有统计学意义(P<0.05)。结论:大柴胡汤合薏仁败酱汤联合西医疗法治疗SAP具有协同作用,可缩短腹痛缓解时间与病程,促进患者恢复。
Objective: To observe the clinical effect of Dachaihu decoction combined with barley decoction and western medicine in the treatment of severe acute pancreatitis (SAP). Methods: Sixty-eight patients with hepatobiliary-damp-heat syndrome were randomly divided into treatment group (34 cases) and control group (34 cases). All patients were routine to gastrointestinal decompression, inhibition of pancreatic enzyme secretion, anti-infection and other treatment, the treatment group with Dachaihu Decoction barley soup, two courses of treatment were 14 days. The curative effect, the APACHEⅡscore and the Ranson score before treatment and 72h after treatment were observed in two groups. The time of abdominal distension, bowel recovery time, defecation time, abdominal pain Disappear time and serum amylase, white blood cells, C-reactive protein (CRP) returned to normal time. Results: After treatment, the cure rate and total effective rate of the treatment group were higher than that of the control group, the differences were statistically significant (P <0.05). The APACHEⅡscore and Ranson score in both groups were significantly lower than those before treatment (P <0.05). The APACHEⅡscore and Ranson score in the treatment group were lower than those in the control group (P <0.05). The treatment time of abdominal distension, bowel sounds recovery time, defecation time, abdominal pain disappearance time and serum amylase, white blood cells, CRP recovery time were shorter than the control group, the difference was statistically significant (P <0.05). Conclusion: Dachaihu decoction combined with barley decoction combined with Western medical treatment of SAP has a synergistic effect, which can shorten the time and course of abdominal pain relief and promote the recovery of patients.