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目的 :观察在常规疗法基础上加用大黄联合生长抑素治疗重症急性胰腺炎(SAP)的效果。方法 :纳入64例SAP肝脾湿热证患者作为研究对象,随机分为试验组与对照组各32例,2组均予抑制胃酸分泌、胃肠减压等常规治疗,试验组以大黄联合生长抑素治疗,对照组予生长抑素治疗,2组疗程均为15天。观察比较2组的临床疗效;记录并比较2组治疗前后血清钙、血清淀粉酶、急性生理和慢性健康评分(APACHE-Ⅱ评分)的变化情况;记录2组腹痛消失时间、腹胀消失时间、肠鸣音恢复时间及排气排便时间。结果:治疗后,试验组总有效率为93.75%,高于对照组(75.00%),差异有统计学意义(P<0.05)。2组血清钙、血清淀粉酶水平均较治疗前改善(P<0.05),试验组血清钙水平高于对照组,血清淀粉酶水平低于对照组,差异均有统计学意义(P<0.05)。2组APACHE-Ⅱ评分均较治疗前降低,试验组APACHE-Ⅱ评分低于对照组,差异均有统计学意义(P<0.05)。试验组腹痛消失时间、腹胀消失时间、肠鸣音恢复时间及排气排便时间均短于对照组,差异均有统计学意义(P<0.05)。结论:在SAP的治疗中应用大黄联合生长抑素治疗方案,有助于改善患者的血清生化指标,迅速改善患者的腹痛、腹胀症状,恢复正常肠鸣音,加快排气,对肠道功能恢复有积极促进作用,临床疗效显著。
Objective: To observe the effect of adding rhubarb combined with somatostatin on severe acute pancreatitis (SAP) based on routine therapy. Methods: Sixty-four patients with SAP spleen-damp-heat syndrome were randomly divided into experimental group and control group (n = 32). Both groups were given conventional therapy such as gastric acid secretion and gastrointestinal decompression. Su-treatment, the control group to somatostatin treatment, two groups of treatment were 15 days. The changes of serum calcium, serum amylase, acute physiology and chronic health score (APACHE-Ⅱ score) before and after treatment were recorded and compared. The disappearance of abdominal pain, disappearance of abdominal distension, Beep recovery time and exhaust defecation time. Results: After treatment, the total effective rate of the experimental group was 93.75%, which was higher than that of the control group (75.00%), the difference was statistically significant (P <0.05). The levels of serum calcium and serum amylase were improved in both groups (P <0.05). The level of serum calcium in the experimental group was higher than that in the control group, and the serum amylase level was lower than that in the control group (P <0.05) . The scores of APACHE-Ⅱ in both groups were lower than those before treatment, and the APACHE-Ⅱ scores in the experimental group were lower than those in the control group. The difference was statistically significant (P <0.05). Abdominal pain disappear time, disappearance of abdominal distension time, bowel sounds recovery time and exhaust defecation time were shorter than the control group, the difference was statistically significant (P <0.05). Conclusion: The application of rhubarb combined with somatostatin in the treatment of SAP can help to improve the patients ’serum biochemical indexes, rapidly improve the patients’ symptoms of abdominal pain and bloating, restore the normal bowel sounds, accelerate the exhaust and restore the intestinal function Have a positive role in promoting the clinical significant effect.