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目的:观察柴芍承气汤鼻饲联合乌司他丁静脉滴注治疗重症急性胰腺炎临床疗效。方法:选取104例重症急性胰腺炎患者,随机分为2组,各52例。对照组给予乌司他丁静脉滴注治疗;治疗组在对照组治疗基础上给予柴芍承气汤中药汤剂鼻饲治疗。观察患者胃肠功能、临床症状、白细胞、血淀粉酶、尿淀粉酶、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及C-反应蛋白(CRP)改善情况;临床疗效及不良反应。结果:总有效率治疗组90.4%,对照组73.1%,2组比较,差异有统计学意义(P<0.05)。治疗组腹痛恢复时间、腹胀恢复时间、排气时间、排便时间较对照组明显缩短,2组比较,差异有统计学意义(P<0.05)。治疗组白细胞、血淀粉酶、尿淀粉酶恢复至正常时间较对照组明显缩短,2组比较,差异有统计学意义(P<0.05)。治疗后2组IL-6、IL-8、CRP水平均较治疗前有明显下降,与治疗前比较,差异有统计学意义(P<0.05)。治疗组降低幅度尤为明显,与对照组比较,差异有统计学意义(P<0.05)。不良反应发生率治疗组7.7%,对照组17.3%,2组比较,差异有统计学意义(P<0.05)。结论:柴芍承气汤鼻饲联合乌司他丁静脉滴注治疗重症急性胰腺炎临床疗效明显,有效改善患者的胃肠功能,抗炎作用显著,不良反应发生率低。
Objective: To observe the clinical effect of Chaishao Chengqi Decoction nasal feeding combined with ulinastatin intravenous infusion in the treatment of severe acute pancreatitis. Methods: A total of 104 patients with severe acute pancreatitis were randomly divided into two groups (n = 52). The control group was treated with ulinastatin intravenously. The treatment group was given Chaishao Chengqi Decoction for nasal feeding on the basis of the control group. To observe the gastrointestinal function, clinical symptoms, white blood cells, blood amylase, urinary amylase, interleukin-6 (IL-6), interleukin-8 and C-reactive protein Clinical efficacy and adverse reactions. Results: The total effective rate was 90.4% in the treatment group and 73.1% in the control group. There was significant difference between the two groups (P <0.05). The abdominal pain recovery time, abdominal distension recovery time, exhaust time and defecation time in the treatment group were significantly shorter than those in the control group. There was significant difference between the two groups (P <0.05). The white blood cells, blood amylase and urinary amylase returned to normal in the treatment group were significantly shorter than those in the control group. There was significant difference between the two groups (P <0.05). The levels of IL-6, IL-8 and CRP in the two groups after treatment were significantly lower than those before treatment, and the difference was statistically significant (P <0.05). The treatment group decreased more significantly, compared with the control group, the difference was statistically significant (P <0.05). The incidence of adverse reactions was 7.7% in the treatment group and 17.3% in the control group, the difference was statistically significant (P <0.05). Conclusion: Chaishao Chengqi soup nasal feeding combined with ulinastatin intravenous infusion for the treatment of severe acute pancreatitis has obvious clinical curative effect, which can effectively improve the gastrointestinal function of patients with significant anti-inflammatory effect and low incidence of adverse reactions.