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目的探讨大黄液在重症急性胰腺炎治疗中的应用及临床疗效。方法将2014年1月至2015年6月收治的70例重症急性胰腺炎患者按照数字表法分为实验组和对照组,每组35例。对照组给予硫酸镁灌肠,实验组行大黄灌肠治疗。对比两组患者治疗后腹胀缓解时间、肠鸣音恢复时间、首次排便时间、平均住院时间及治疗前、治疗后7、14 d血淀粉酶水平、血白细胞计数、C反应蛋白(CRP)水平及治疗前、治疗后3、7 d Balthazar CT积分、ARACHEⅡ评分。结果实验组患者腹胀缓解时间、肠鸣音恢复时间均显著少于对照组(t=4.436,t=3.746,P均<0.01),首次排便时间、平均住院时间与对照组比较无统计学差异(t=0.742,t=0.465,P均>0.05)。治疗后3、7 d Balthazar CT积分、ARACHEⅡ评分两组比较无统计学差异(P均>0.05)。治疗后7 d,实验组CRP水平显著低于对照组(t=2.009,P<0.05)。结论大黄灌肠治疗重症急性胰腺炎可有效缓解临床症状,提高临床疗效。
Objective To investigate the application and clinical efficacy of rhubarb in the treatment of severe acute pancreatitis. Methods Seventy patients with severe acute pancreatitis admitted from January 2014 to June 2015 were divided into experimental group and control group according to digital table method, with 35 cases in each group. Control group given magnesium sulfate enema, experimental group rhubarb enema treatment. The duration of bloating, bowel sounds recovery time, first defecation time, average length of hospital stay, blood amylase levels, blood leukocyte counts, C-reactive protein (CRP) levels at 7 and 14 days after treatment were compared between the two groups after treatment Balthazar CT score and ARACHE Ⅱ score before treatment and 3 and 7 days after treatment. Results In the experimental group, the durations of abdominal distension and recovery of bowel sounds were significantly less than those in the control group (t = 4.436, t = 3.746, P <0.01). There was no significant difference in the first defecation time and the average length of hospital stay between the two groups t = 0.742, t = 0.465, P> 0.05). At 3 and 7 days after treatment, Balthazar CT scores and ARACHE Ⅱ scores showed no significant difference between the two groups (all P> 0.05). At 7 days after treatment, CRP level in the experimental group was significantly lower than that in the control group (t = 2.009, P <0.05). Conclusion rhubarb enema for severe acute pancreatitis can effectively relieve clinical symptoms and improve clinical efficacy.