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目的:观察培菲康鼻饲联合清胰汤灌肠治疗肝胆湿热型急性重症胰腺炎(SAP)的疗效。方法:全部40例SAP患者随机分为两组,对照组(n=20)给予醋酸奥曲肽注射液0.1mg,每日3次,皮下注射。治疗组(n=20)在上述治疗基础上加用清胰汤(大承气汤加减),每日2次水煎灌肠;培菲康420mg,每日3次,鼻饲。两组均治疗14天。观察治疗前后患者腹痛等症状消失天数,平均住院天数及治疗7天后血清淀粉酶(AMY)等指标的变化情况和1个月病死率。结果:治疗组总有效率90%,对照组总有效率70%,两组相比较差异有显著意义(P<0.05)。与对照组相比,治疗组治疗后腹痛等症状消失时间及平均住院天数均明显缩短(P<0.05),治疗组治疗后血清淀粉酶等指标下降更明显(P<0.05或P<0.01)。结论:培菲康鼻饲联合清胰汤灌肠治疗肝胆湿热型急性重症胰腺炎疗效肯定。
Objective: To observe the curative effect of Peficon nasal feeding and Qingyitang enema in the treatment of acute severe pancreatitis with hepatobiliary-gallbladder damp-heat syndrome (SAP). Methods: All 40 SAP patients were randomly divided into two groups. The control group (n = 20) was given 0.1 mg octreotide acetate injection three times a day for subcutaneous injection. Treatment group (n = 20) based on the above treatment plus Qingyi Tang (Dachengqi Decoction), 2 times a day decoction enema; Pefeiconazole 420mg, 3 times a day, nasal feeding. Both groups were treated for 14 days. Before and after treatment, the number of days of disappearance of abdominal pain and other symptoms, the average number of days of hospitalization and serum amylase (AMY) after 7 days of treatment and other indicators of change and 1-month mortality. Results: The total effective rate was 90% in the treatment group and 70% in the control group. There was significant difference between the two groups (P <0.05). Compared with the control group, the disappearance time of abdominal pain and other days and the average length of stay in the treatment group were significantly shorter (P <0.05). The serum amylase and other indexes decreased more significantly in the treatment group after treatment (P <0.05 or P <0.01). Conclusion: The combination of Peficon nasal feeding and Qingyitang enema in the treatment of acute severe pancreatitis with hepatobiliary and damp-heat syndrome is effective.