早期应用柴芩承气汤治疗重症急性胰腺炎伴多器官功能障碍综合征临床研究

目的：探讨早期应用柴芩承气汤治疗重症急性胰腺炎（severe acute pancreatitis,SAP）伴多器官功能障碍综合征（multiple organ dysfunction syndrome,MODS）的临床疗效。方法：88例符合病例选择标准并接受柴芩承气汤治疗的SAP伴MODS住院患者,按院外病程长短分为早期组（48 h内入院接受治疗,44例）和晚期组（48~72 h内入院接受治疗,44例）,比较治疗过程中两组患者器官功能障碍持续时间、住院时间、感染率、中转手术率及病死率。结果：早期组急性呼吸窘迫综合征、肾功能衰竭、心功能衰竭、肝功能不全、脑病、凝血系统损害的持续时间低于晚期组（P〈0.05）;早期组住院时间、感染率、中转ICU率、中转手术率及病死率低于晚期组（P〈0.05）。结论：早期应用柴芩承气汤治疗SAP伴MODS能减少器官损害持续时间,减轻器官损害,从而缩短病程,减少后期感染率及中转手术率,降低病死率。

Clinical Study of Chaiqin Chengqi Decoction in Treating Severe Acute Pancreatitis Accompanied with Multiple Organ Dys-function Syndrome in Early Stage

Objective： To explore the therapeutic effects of Chaiqin Chengqi Decoction （CQCQD） in treating severe acute pancreatitis（SAP） accompanied with multiple organ dysfunction syndrome（MODS） in early stage. Methods： Eighty-eight patients with SAP accompanied with MODS were treated with CQCQD, and they were divided into two groups., early-treated group （44 patients treated with CQCQD within 48 hours after the onset of SAP） and late-treated group （44 patients treated with CQCQD between 48 and 72 hours after the onset of SAP）. The organ damage sustained time, hospitalization period, infection rate, operation rate and mortality rate were examined. Results： The duration of acute respiratory distress syndrome, acute renal failure, congestive heart failure, hepatic inadequacy, encephalopathy and coagulation system damage in early group were lower than those in late group （P〈0.05）. The hospitalization period, infection rate, operation rate and mortality rate in early group were lower than those in late group （P〈0.05）. Conclusion： CQCQD has a good therapeutic effect in treating SAP accompanied with MODS in early stage. It can cut down organ damage sustained time, lighten organ damage, shorten course of disease, thereby, reduce mortality rate.