柴胡承气汤结合奥曲肽治疗重症急性胰腺炎的临床研究

目的探讨柴胡承气汤结合醋酸奥曲肽注射液对重症急性胰腺炎(severe acute pancreatitis,SAP)患者血清胃泌素(GAS)、胃动素(MTL)和血管活性肠肽(VIP)水平的影响。方法选取2018年7月—2019年11月本院收治的SAP患者70例,按照随机数字表法分为研究组和对照组,每组35例。在常规治疗基础上,对照组患者采用醋酸奥曲肽注射液治疗,研究组患者在对照组治疗基础上加用柴胡承气汤治疗。比较2组患者治疗前后血清GAS、MTL和VIP水平变化,比较2组患者临床症状改善时间及住院时间长短。结果治疗后,2组患者血清GAS、VIP水平均较治疗前明显降低,且研究组显著低于对照组(P<0.05);2组患者血清MTL水平均较治疗前明显升高,且研究组显著高于对照组(P<0.05);研究组患者腹胀消失时间、腹痛消失时间、肠鸣音恢复时间及住院时间均显著短于对照组(P<0.05)。结论应用柴胡承气汤联合醋酸奥曲肽注射液治疗SAP患者,可有效改善胃肠激素水平,加快临床症状缓解,缩短住院时间。

Clinical Study of Chaihu Chengqi Decoction Combined with Octreotide in the Treatment of Severe Acute Pancreatitis

Objective To investigate the effect of Chaihu Chengqi decoction combined with octreotide acetate injection on serum gastrin(GAS),motilin(MTL)and vasoactive intestinal peptide(VIP)levels in patients with severe acute pancreatitis(SAP).Methods From July 2018 to November 2019,seventy patients with severe acute pancreatitis treated in our hospital were selected and divided into study group and control group according to the random digital table method,with 35 cases in each group.On the basis of routine treatment,the patients in the control group were treated with octreotide acetate injection,while the patients in the study group were treated with Chaihu Chengqi decoction on the basis of treatment in the control group.The levels of serum GAS,MTL and VIP before and after treatment were compared between the two groups,the time of clinical symptom improvement and the length of hospital stay were compared between the two groups.Results After treatment,the levels of serum GAS and VIP in the two groups were significantly lower than those before treatment,and the study group was significantly lower than that of the control group(P<0.05).The levels of serum MTL in the two groups were significantly higher than those before treatment,and the study group was significantly higher than that in the control group(P<0.05).The time for the disappearance of abdominal distension,the time for the disappearance of abdominal pain,the time for recovery of bowel sounds and the length of hospital stay in the study group were significantly shorter than those in the control group(P<0.05).Conclusion The application of Chaihu Chengqi decoction combined with octreotide acetate injection in patients with severe acute pancreatitis could effectively improve the levels of gastrointestinal hormones,accelerate the relief of clinical symptoms,and shorten the length of hospitalization.