早期应用柴芩承气汤治疗重症急性胰腺炎并发急性呼吸窘迫综合征的临床观察

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）并发急性呼吸窘迫综合征（acute respiratory distress syndrome, ARDS）的疗效。

Effect of an Early Application of Chaiqin Chengqi Decoction in Treating Severe Acute Pancreatitis Complicated with Acute Respiratory Distress Syndrome

Objective To investigate the therapeutic effects of an early application of Chaiqin Chengqi Decoction （CQCQD） on severe acute pancreatitis （SAP） complicated with acute respiratory distress syndrome （ARDS）. Methods Forty patients of SAP-ARDS were equally randomized into the early-treated group （ET） and the late-treated group （ LT）, CQCQD was administered to them immediately and 3 days later after hospitalization respectively. Baseline materials in the two groups at the entry were insignificantly different （ P 〉 0.05）, and the same conventional Western medical therapy were available to them all. The Acute Physiology and Chronic Heath Evaluation Ⅱ （APACHE Ⅱ） scores, the incidence and sustained time of complications, the occurrence of infection, requirement of operation shifting on day 7, as well as the duration resided in hospital and mortality in patients were observed and compared. Results Comparisons of the above-mentioned clinical indexes between groups showed that the APACHE Ⅱ score was lower （5.1±2.0 scores vs 9.3 ＋4.3 scores, P〈0. 01） ; the incidence of shock was lesser （1/20 vs 7/19） ; the duration of ARDS, renal failure, cardiac insufficiency, hepatic dysfunction, cerebropathy and enteroplegia, as well as the duration in hospital and the requirement of operation shifting were all shorter significantly （ P 〈 0.05） in the ET group than those in the LT group, but no statistical difference （ P 〉0.05） was shown in terms of the infection incidence and the mortality. Conclusion An early application of CQCQD in the treatment of SAP could shorten the duration of complications and the couse of disease, lower the requirement of operation shifting. But further study with large samples for explore its impact on the infection incidence and the mortality is needed.