黄龙汤对重症急性胰腺炎患者急性胃肠损伤的疗效研究

目的观察黄龙汤灌肠治疗重症急性胰腺炎患者合并急性胃肠损伤的临床疗效并探讨其作用机制。方法92例患者随机分为对照组和灌肠组。对照组给予西医常规治疗和护理,灌肠组加用黄龙汤灌肠治疗,连续治疗7 d。比较两组的临床疗效、中医证候积分、急性生理与慢性健康评分(APACHEⅡ)、胃肠功能障碍评分、胃肠功能恢复时间、住院时间、腹内压,记录两组28 d并发症发生率。结果治疗后,灌肠组总有效率95.65%高于对照组的82.61%(P<0.05)。两组治疗前APACHEⅡ、中医证候积分、胃肠功能障碍评分比较,差异无统计学意义(均P>0.05)。两组治疗后APACHEⅡ、中医证候积分、胃肠功能障碍评分均较治疗前降低,且治疗组降低程度优于对照组(均P<0.05)。治疗后,灌肠组腹胀缓解时间、腹痛缓解时间、自主排便时间、首次排气时间、肠鸣音恢复时间和住院时间均低于对照组(P<0.05)。治疗前,两组腹内压比较,差异无统计学意义(P>0.05)。治疗后,两组腹内压均较治疗前降低,且治疗组降低程度优于对照组(P<0.05)。灌肠组28 d并发症发生率4.35%低于对照组的15.22%(P<0.05)。结论黄龙汤灌肠治疗重症急性胰腺炎患者可以恢复胃肠功能,减少并发症。

Effects of Huanglong Decoction on Acute Gastrointestinal Injury in Patients with Severe Acute Pancreatitis

Objective:To study the effects of Huanglong Decoction by enema on patients with severe acute pancreatitis complicated with acute gastrointestinal injury.Methods:92 patients were randomly divided into the control group and enema group.The control group received routine treatment and nursing.Enema group received Huanglong Decoction by enema additionally for 7 days.The clinical efficacy,TCM syndrome score,APACHE II score,gastrointestinal dysfunction score,gastrointestinal function recovery time,hospital stay,intra-abdominal pressure were compared.The complication rate of the two groups was recorded in 28 days.Results:The total effective rate of enema group was significantly higher than that of the control group(P<0.05).TCM syndrome score,APACHE II score,gastrointestinal dysfunction score and intra-abdominal pressure of the two groups decreased significantly(P<0.05),but enema group decreased significantly than the control group(P<0.05).The bloating,abdominal pain relief time,spontaneous defecation time,first anal exhaust time,bowel sound recovery time and hospitalization time in enema group were lower than in the control group(P<0.05).The incidence of symptoms was significantly lower than that of the control group(P<0.05).Conclusion:Huanglong Decoction can restore gastrointestinal function and reduce complications in patients with severe acute pancreatitis.