大承气汤联合清热通腑灌肠方治疗急性胰腺炎疗效研究

目的:观察大承气汤联合清热通腑灌肠方治疗急性胰腺炎的临床疗效。方法:将96例已经确诊为急性胰腺炎的患者采用简单随机法分为对照组(n=48)和观察组(n=48)。对照组给予奥曲肽治疗，而观察组在奥曲肽基础上给予大承气汤口服联合清热通腑灌肠方保留灌肠治疗。比较两组胰腺体部血流指标、中医证候积分、Balthazar CT重症度指数分级及血淀粉酶的差异，统计两组临床疗效。结果:两组患者治疗前中医证候积分、Balthazar CT重症度指数分级比较，差异无统计学意义(均P>0.05)。两组中医证候总积分、主证和次证积分在治疗后均下降，且观察组中医证候总积分低于对照组，差异有统计学意义(均P<0.05)。治疗后观察组Balthazar CT重症度指数分级中Ⅰ级占比增加，Ⅲ级占比减少。治疗前，两组患者胰腺体部血流指标、血淀粉酶比较，差异无统计学意义(均P>0.05)。治疗后，两组胰腺体部血流量(BF)、血容量(BV)均高于治疗前，血淀粉酶及胰腺体部毛细血管表面通透性(PS)均低于治疗前，差异有统计学意义(均P<0.05)。治疗后，观察组胰腺体部BF、BV高于对照组，胰腺体部P...

Efficacy study on Dachengqi decoction combined with Qingre Tongfu Guanchang decoction in treating acute pancreatitis

Objective:To observe the clinical effect of Dachengqi decoction combined with Qingre Tongfu Guanchang decoction on acute pancreatitis.Methods:96 patients with acute pancreatitis were randomly divided into control group(n=48)and observation group(n=48).The control group were treated with octreotide,while the observation group were treated with Dachengqi decoction and Qingre Tongfu Guanchang decoction retention enema based on octreotide.Compared difference between the two groups in terms of pancreatic body blood flow index,TCM symptom score,Balthazar CT severity index grading and blood amylase,and to calculate curative effect of the two groups.Results:Before treatment,there were no difference in TCM symptom score and Balthazar CT severity index grading between the two groups,no statistically significant difference(all P>0.05).After treatment,total TCM symptom score and its main and secondary syndrome scores of the two groups decreased,and total TCM symptom score in the observation group were lower than those in the control group,difference statistically significant(all P<0.05).After treatment,the proportion of Balthazar CT severity index grade Ⅰ in the observation group increased and the proportion of grade Ⅲ decreased.Before treatment,there were no difference in blood flow index and blood amylase between the two groups(all P>0.05).After treatment,blood flow(BF)and blood volume(BV)of the two groups increased,and blood amylase and capillary surface permeability(PS)of the pancreatic body decreased,difference statistically significant(all P<0.05).After treatment,BF and BV of the pancreatic body in the observation group were higher than those in the control group,and the PS and blood amylase of the pancreatic body were lower than those in the control group,difference statistically significant(all P<0.05).The total effective rate in the observation group was 91.67%(44/48)higher than 75.00%(36/48)in the control group,difference statistically significant(P<0.05).Conclusion:Dachengqi decoction combined with Qingre Tongfu Guanchang decoction can effectively reduce the imaging changes of the pancreas,improve hemodynamics of the pancreas body and efficacy of acute pancreatitis.