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[目的]观察如意止痛膏外敷联合西医治疗急性胰腺炎疗效。[方法]使用随机平行对照方法,将64例住院患者按抽签法随机分为两组。对照组32例基础治疗:①禁食、水,胃肠减压,改善胃肠功能紊乱导致的腹胀,缓解呕吐或肠梗阻等症状;②补液,纠正水、电解质紊乱,防止出现低血压及休克;③抑制胰腺分泌,使胰腺处于“休息状态”。奥曲肽,0.2mg/次,3次/d,静脉泵入;④镇静、止痛,布桂嗪(强痛定)100mg/次,肌注;必要时肌注哌替啶(杜冷丁)100mg/次;⑤营养支持,早期全肠外营养,肠功能恢复后,逐渐增加肠内营养,最终完全替代肠外营养;⑥对症处理,保护重要脏器功能。治疗组32例如意止痛膏,生大黄500g,川芎、元胡、厚朴、芒硝各100g,冰片、甘草各50g,饴糖适量;大黄、厚朴、川芎、玄胡、甘草磨粉过筛;饴糖加热熔化;细粉与芒硝混匀,加入熔化饴糖中,加40%二甲基矾搅拌,冷至40°,加入冰片混匀;分摊50纸上或布上,即得;将如意止痛膏外敷于胰腺体表投影区、脐部和局部炎性包块处,一日一换;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈24例,好转6例,无效2例,总有效率93.75%。对照组痊愈19例,好转9例,无效4例,总有效率87.50%。治疗组疗效优于对照组(P<0.05)。症状缓解治疗组优于对照组(P<0.05)。指标恢复时间治疗组优于对照组(P<0.05)。[结论]如意止痛膏外敷联合西医治疗急性胰腺炎效果显著,值得推广。
[Objective] To observe the curative effect of Ruyi Zhitong Ointment combined with western medicine on acute pancreatitis. [Methods] Using randomized parallel control method, 64 inpatients were randomly divided into two groups according to random selection. The control group of 32 cases of basic treatment: ① fasting, water, gastrointestinal decompression, improve gastrointestinal disorders caused by abdominal distension, relieve vomiting or intestinal obstruction and other symptoms; ② rehydration, correct water and electrolyte disorders, to prevent hypotension and shock ; ③ inhibition of pancreatic secretion, the pancreas in the “rest state”. Octreotide, 0.2mg / time, 3 times / d, intravenous infusion; ④ sedative, analgesic, cloth Guizin (strong pain) 100mg / times, intramuscularly; if necessary pethidine (pethidine) 100mg / times ; ⑤ nutritional support, early total parenteral nutrition, intestinal function recovery, and gradually increase enteral nutrition, and ultimately completely replace parenteral nutrition; ⑥ symptomatic treatment to protect the function of important organs. The treatment group 32, for example, Zhi Zhitong cream, rhubarb 500g, Chuanxiong, Yuan Hu, Magnolia, Glauber’s 100g, borneol, licorice each 50g, caramel amount; rhubarb, Magnolia, Chuanxiong, Xuanhu, licorice flour sieved; Heating and melting; fine powder and mirabilite mixing, adding melted caramel, plus 40% dimethyl alum stirred, cooled to 40 °, add borneol mix; spread 50 paper or cloth, that is; In the pancreatic body surface projection area, umbilical and local inflammatory mass at the same day; Western medicine treatment with the control group. Continuous treatment 7d for a course of treatment. Observed clinical symptoms, adverse reactions. Treatment of a course of treatment to determine the efficacy. [Result] The treatment group was cured in 24 cases, improved in 6 cases, ineffective in 2 cases, the total effective rate was 93.75%. The control group cured 19 cases, improved in 9 cases, 4 cases, the total effective rate was 87.50%. The treatment group was better than the control group (P <0.05). The symptom relief group was better than the control group (P <0.05). The index recovery time was better in the treatment group than in the control group (P <0.05). [Conclusion] Ruyi Zhitong Ointment combined with Western medicine has a significant effect in treating acute pancreatitis and is worth popularizing.