早期应用柴芩承气汤治疗胆源性重症急性胰腺炎的临床研究

目的:探讨早期应用柴芩承气汤治疗胆源性重症急性胰腺炎(severe acute pancreatitis,SAP)的疗效.方法:90例符合病例选择标准并接受柴芩承气汤治疗的胆源性SAP住院患者,按院外病程长短分为早期组(3 d内入院接受治疗,54例)和晚期组(3～7 d内入院接受治疗,36例),比较治疗过程中两组患者并发症的发生率、住院时间、手术中转率及病死率.结果:早期组胰性脑病、感染和消化道出血的发生率明显低于晚期组(P＜0.05).早期组和晚期组住院时间分别为(24.9±18.4)d和(51.6±45.9)d,早期组和晚期组病死率分别为7.4%(4/54例)和25.0%(9/36例),早期组和晚期组中转手术率分别为11.1%(6/54例)和27.8%(10/36例),两组比较差异均有统计学意义(P＜0.05).结论:早期应用柴芩承气汤治疗胆源性SAP,可减少并发症的发生、缩短住院时间、减少手术中转率及降低病死率.

Clinical study of Chaiqin Chengqi Decoction in treating severe acute biliary pancreatitis

OBJECTIVE: To study the therapeutic effects of Chaiqin Chengqi Decoction (CQCQD) in treating severe acute biliary pancreatitis. METHODS: Ninety patients with severe acute biliary pancreatitis were treated with CQCQD, and they were divided into two groups: early-treated group (54 patients treated with CQCQD within 3 days after the onset of severe acute biliary pancreatitis) and late-treated group (36 patients treated with CQCQD between 3 and 7 days after the onset of severe acute biliary pancreatitis). The complication incidence rate, operation rate, mortality rate and hospitalization period were examined. RESULTS: The incidence rates of encephalopathy, infection and gastrointestinal hemorrhage were lower in the early-treated group than those in the late-treated group (P<0.05). The hospitalization periods of the early- and late-treated groups were (24.9+/-18.4) days and (51.6+/-45.9) days respectively (P<0.05). The general mortality rate was 14.4%. The mortality rate of the early-treated group (7.4%) was significantly lower as compared with that of the late-treated group (25.0%) (P<0.05). The operation rate of the early-treated group (11.1%) was also significantly lower as compared with that of the late-treated group (27.8%) (P<0.05). CONCLUSION: Treating severe acute biliary pancreatitis with CQCQD in early stage may reduce the complication incidence rate, shorten the hospitalization period, and decrease the operation rate and mortality rate.