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目的:探讨柴芍承气汤灌肠联合生长抑素治疗重症胰腺炎的临床疗效。方法:选择66例重症胰腺炎患者为研究对象,按照随机原则分为治疗组和对照组。对照组采用生长抑素等基础治疗方法,治疗组在对照组治疗基础上,采用柴芍承气汤灌肠治疗。经治疗后,观察两组患者治疗前后临床症状体征变化,评估患者治疗前后腹内高压、肠道黏膜屏障功能的改善状况以及相关炎性因子的含量。结果:治疗组治疗后总有效率为93.9%,显著高于对照组的78.8%(P<0.05);治疗后,两组IAP、D-乳糖及DAO含量均明显降低(P<0.05),治疗组IAP、D-乳糖及DAO含量均显著低于对照组(P<0.05);治疗组主要临床症状及生化指标恢复正常所用时间均显著短于对照组(P<0.05);两组治疗后IL-6、TNF-α指标均显著降低(P<0.05),而Ig A指标显著升高(P<0.05);治疗组治疗后IL-6、TNF-α指标均显著低于对照组(P<0.05),而Ig A指标显著高于对照组(P<0.05)。结论:柴芍承气汤灌肠联合生长抑素能够改善重症胰腺炎患者的临床症状,降低患者腹内高压,促进肠道黏膜屏障功能快速恢复,抑制病情继续恶化,提高患者的生存质量。
Objective: To investigate the clinical efficacy of Chai Sha Cheng Cheng Qi Decoction combined with somatostatin in the treatment of severe acute pancreatitis. Methods: Sixty-six patients with severe acute pancreatitis were selected as study subjects and divided into treatment group and control group according to the randomized principle. The control group used somatostatin and other basic treatment methods, the treatment group in the control group based on the treatment of Chai Cheng Chengqi soup enema treatment. After treatment, the changes of clinical symptoms and signs before and after treatment were observed in both groups to evaluate the improvement of intra-abdominal hypertension and intestinal mucosal barrier function before and after treatment and the content of related inflammatory factors. Results: After treatment, the total effective rate was 93.9% in the treatment group, which was significantly higher than 78.8% in the control group (P <0.05). After treatment, the levels of IAP, D-lactose and DAO were significantly decreased The levels of IAP, D-lactose and DAO in the treatment group were significantly lower than those in the control group (P <0.05). The main clinical symptoms and biochemical indexes returned to normal in the treatment group were significantly shorter than those in the control group (P <0.05) (P <0.05), while the Ig A was significantly increased (P <0.05). The levels of IL-6 and TNF-α in the treatment group were significantly lower than those in the control group (P < 0.05), while the Ig A index was significantly higher than that of the control group (P <0.05). Conclusion: Chaishao Chengqi Decoction combined with somatostatin can improve the clinical symptoms of patients with severe pancreatitis, reduce intra-abdominal high pressure, and promote the rapid recovery of intestinal mucosal barrier function, inhibit the progression of the disease and improve the quality of life of patients.