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1、赤芍煎剂治疗重症急性胰腺炎随机对照临床研究作者:张敏,朱德增,李兆申,湛先保【摘要】比较赤芍煎剂和生大黄治疗早期重症急性胰腺炎(severeacutepancreatitis,SAP)的临床疗效。方法:将符合SAP诊断标准的96例患者随机分成两组。对照组48例,应用常规西医疗法加用生大黄15~30g开水泡制150ml,胃管内注入后夹闭胃管30~60min,2次/d,必要时加以灌肠;治疗组48例,在西医疗法基础上加用赤芍煎剂,用法同对照组。观察指标:腹胀、发热、腹部压痛消失时间;抗生素、胰酶抑制剂、蛋白酶抑制剂应用时间;发病至肠内营养应用时间、鼻空肠营养时
2、间;胃肠减压时间、禁食时间;平均住院日、住院费用及死亡率;两组中药应用过程中的不良反应等。结果:治疗组患者的腹部压痛、腹胀、发热时间均少于对照组(P<0.05);治疗组应用抗细菌药物、抗真菌药物的时间短于对照组(P<0.05);两组抑制胰腺分泌药物及蛋白酶抑制剂应用时间比较,差异无统计学意义(P>0.05);治疗组的患者可以更快地耐受鼻空肠内营养,其肠内营养时间、胃肠减压时间及禁食时间均短于对照组,治疗组住院时间及费用均少于对照组(P<0.05)。两组死亡率及用药副反应比较,差异亦无统计学意义(P>0.05)。结论:赤芍煎剂
3、同单味生大黄比较,其治疗SAP的疗效更明显,病人耐受程度好。【关键词】急性坏死性胰腺炎;中医疗法;中西医结合;赤芍;大黄 Objective:Tocomparethetherapeuticeffectsofredpeonyrootdecoction,acompoundtraditionalChineseherbalmedicine,andrhubarbintreatingsevereacutepancreatitis(SAP).Methods:Atotalof96consecutivepatientswithobjectivelygradedSAPw
4、ererandomlydividedintotreatmentandcontrolgroups.Therewere48casesineachgroup.Thepatientsinthetreatmentandcontrolgroupswereassignedtoreceiveredpeonyrootdecoctionandrhubarbtreatment12timesadayviaagastrictuberespectively.Comparisonsinthetimeneededforthedisappearanceofabdominaltender
5、ness,feverandabdominaldistensionweremadebetweenthetwogroups.Thetotaldaysofusingantibiotics,enzymeinhibitor,proteaseinhibitor,andnasojejunalfeedingstart,nasojejunalfeeding,gastrointestinaldecompression,fastingdietwerealsocompared.Andcomparisonalsoincludedhospitalstaysandhospitaliz
6、ationcosts.Results:Thedurationsofabdominaltenderness,feverandabdominaldistensioninthetreatmentgroupwerelessthanthoseinthecontrolgroup(P<0.05).Comparedwiththecontrolgroup,thetimelengthforantibiotics(includingantibacteriadrugandantifungalagent)use,nasojejunalfeedingstart,nasoje
7、junalfeeding,gastrointestinaldecompression,fastingdiet,hospitalstays11andhospitalizationcostsweredecreasedinthetreatmentgroup(P<0.05).Therewerenosignificantdifferencesbetweenthetwogroupsinenzymeinhibitorandproteaseinhibitorrequirement,mortalityandadversereactions.Conclusion:Re
8、dpeonyrootdecoctionismoreeffectivethanrh