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[目的]观察大承气汤联合生长抑素治疗老年人重症急性胰腺炎疗效。[方法]使用随机平行对照方法,将62例住院患者住院号抽签简单随机分两组;常规禁食、胃肠减压,予抑酸药、抗胆碱药物、抗生素,补充血容量和电解质以及对症支持治疗。对照组25例生长抑素3mg+5%葡萄糖(或氯化钠)50m L,持续静脉泵入。治疗组37例大承气汤(大黄、芒硝各10g,枳实、厚朴各15g),1剂/d,水煎400m L,早晚口服或鼻饲;生长抑素治疗同对照组。连续治疗10d为1疗程。观测临床症状、血淀粉酶、血白细胞、血钙、细胞因子、不良反应。治疗1疗程,判定疗效。[结果]血淀粉酶、血白细胞、血钙、TNF-α、IL-6、IL-8改善治疗组优于对照组(P<0.05)。[结论]大承气汤联合生长抑素治疗老年人重症急性胰腺炎,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the therapeutic effect of Dachengqi Decoction combined with somatostatin on severe acute pancreatitis in the elderly. [Methods] Randomized parallel control method was used to randomly divide inpatient lottery of 62 inpatients into two groups randomly: conventional fasting, gastrointestinal decompression, antacids, anticholinergic drugs, antibiotics, blood volume and electrolytes and symptomatic support treatment. Control group 25 patients somatostatin 3mg + 5% glucose (or sodium chloride) 50m L, continuous intravenous infusion. The treatment group 37 cases of Dachengqi Decoction (Rhubarb, Glauber’s salt 10g, citrus aurantium, Magnolia 15g each), 1 / d, decoction 400m L, morning and evening oral or nasal feeding; somatostatin treatment with the control group. Continuous treatment of 10d for a course of treatment. Clinical symptoms, blood amylase, white blood cells, serum calcium, cytokines and adverse reactions were observed. Treatment of a course of treatment to determine the efficacy. [Results] The blood amylase, blood leucocyte, serum calcium, TNF-α, IL-6 and IL-8 in treatment group were better than those in control group (P <0.05). [Conclusion] Dachengqi Decoction combined with somatostatin in the treatment of severe acute pancreatitis in the elderly has satisfactory curative effect and no serious adverse reactions, which deserves promotion.