摘要
目的观察赤芍加清胰汤联合空肠营养治疗重症急性胰腺炎(SAP)的临床疗效。方法 SAP患者60例,随机分为对照组25例,治疗组35例。所有患者给予镇痛、液体复苏、全肠外营养、抑制胰酶分泌和抗感染等常规治疗。对照组在常规治疗基础上应用赤芍加清胰汤治疗,治疗组先给予赤芍加清胰汤,评估肠功能恢复后在内镜引导下放置鼻空肠营养管行肠内营养。观察指标:(1)腹痛/腹胀消失时间、血清淀粉酶恢复正常时间、APACHEⅡ评分和平均住院时间;(2)感染率、转手术率、病死率;(3)炎性介质:TNF-α、IL-6;(4)肠屏障通透性指标:尿乳果糖/甘露醇比值(L/M)、血浆二胺氧化酶(DAO)含量。结果与对照组比较,治疗组腹痛/腹胀持续时间、血清淀粉酶恢复正常时间和平均住院时间均明显缩短,APACHEⅡ评分明显下降,感染率、转手术率及病死率明显降低,肠通透性明显改善,血TNF-α、IL-6含量逐渐下降,差异均有统计学意义(P<0.05)。结论赤芍、清胰汤、空肠营养三者联合治疗,有保护肠道肠黏膜通透性、促进肠道蠕动及改善胰腺微循环等多种作用,从而改善SAP患者的临床症状,减少并发症的发生。
Objective To examine the efficacy of Qingyitang and red peony root combined with enteral nutrition on severe acute pancreatitis.Methods A total of 60 patients with SAP were randomly divided into experimental group（n=35） and control group（n=25）.Routine treatment were given to all patients,the control group takes mainly red peony root and Qingyitang on the basis-of routine therapy.Enteral nutrition was used in the experimental group on the basis of the control group.Observing and checking two groups of the clinical outcomes,the serum IL-6,and TNF-α.Results In experimental group,the clinical outcomes were significantly better than control group,the levels of IL-6 and TNF-αwere significantly lower, gut barrier function were improved（all P 0.05）.Conclusion Qingyitang and red peony root combined with enteral nutrition can protect gut barrier function,therefore improve symptoms and reduce complications.
出处
《疑难病杂志》
CAS
2013年第1期32-34,共3页
Chinese Journal of Difficult and Complicated Cases
基金
河北省科学技术研究及发展项目(No.10276105D-49)
邯郸市科学技术研究及发展项目(No.0823108067-2)
关键词
重症急性胰腺炎
赤芍
清胰汤
胃肠内营养
Severe acute pancreatitis
Red peony root
Qingyitang
Enteral nutrition
