大黄配合乌司他丁治疗急性胰腺炎临床研究

目的:观察大黄配合乌司他丁治疗急性胰腺炎(acute pancreatitis,AP)的临床效果。方法:选取本院2011年1月—2016年1月收治的AP患者105例,随机均分为对照组、DH1组、DH2组、DH3组、DH4组、DH5组及DH6组,每组15例。对照组给予内科常规对症治疗;DH1组、DH2组及DH3组在对照组的基础上加用大黄药液鼻空肠管灌注法治疗,各组给药剂量依次为DH1组日1次,DH2组每12 h 1次、日2次,DH3组每8 h 1次、日3次;DH4组、DH5组及DH6组在对照组的基础上加用大黄药液胃管注入法治疗,各组给药剂量分别为DH4组日1次,DH5组每12 h 1次、日2次,DH6组每8 h 1次、日3次。观察各组血清淀粉酶(AMS)恢复、腹部体征消失及肠道功能恢复时间,治疗前后血清肿瘤坏死因子-α(TNF-α)及白介素-6(IL-6)水平。结果:DH3组AMS恢复时间、腹部体征消失时间、肠道功能恢复时间及IL-6、TNF-α水平优于对照组、DH1组、DH2组(P0.05);DH6组AMS恢复时间、腹部体征消失时间、肠道功能恢复时间及IL-6与TNF-α水平优于对照组、DH4组、DH5组(P0.05);经空肠管灌注的DH3组各临床观察指标改善情况优于经胃管注入的DH6组(P0.05)。结论:采用30 g大黄经空肠管注入配合乌司他丁治疗AP的临床效果更为突出。

The Clinical Research into Acute Pancreatitis Treated with Dahuang in Combination with Ulinastatin

Objective:To observe the clinical curative effect of Dahuang (Radix et Rhizoma Rhei) in combination with ulinastatin on acute pancreatitis (AP).Methods:One hundred and five patients with AP who were treated in our hospital between Jan.of 2011 and Jan.of 2016 were chosen as the research objects,and randomly group,divided into the control group,DH1 group,DH2 group,DH3 group,DH4 group,DH5 group,and DH6 group,with 15 cases in each group.The ones in the control group were given routine internal symptomatic treatment,while the ones in the DHI group,DH2 group,DH3 group were added Dahuang fluid for nasal jejunal tube perfusion method based on the treatment of the control group.The drug dose of DH1 group 1 was taken once a day;For DH2 group,once every 12 hours and twice a day;For DH3 group,once every 8 hours and three times a day;For DH4 group,DH5 group,and DH6 groups,Dahuang fluid were added for gastric perfusion,and for DH4 group,once a day;For DH5 group,once every 12 hours and twice a day;For DH3 group,once every 8 hours and three times a day.Then each group's AMS recovery time,abdominal signs disappearing time and the intestinal function recovery time,TNF-α and IL-6 levels before and after treatment were observed.Results:AMS recovery time,abdominal signs disappearing time and the intestinal function recovery time,TNF-α and IL-6 levels of DH3 group were all better than those of DH1 group,DH2 group,and the control group (P ＜ 0.05).Those of DH2 group were all better than those of the control group,DH1 group,and DH2 group (P ＜ 0.05).Each clinical observed index improvement of DH3 which was treated with nasal jejunal tube perfusion method was better than that of DH6 group which was treated with gastric perfusion (P ＜ 0.05).Conclusion:Using 30g of Dahuang for nasal jejunal tube perfusion in combination with ulinastatin has a better clinical curative effect on AP.