【摘要】 目的:探讨清下解胰方对重症胰腺炎患者肠屏障功能的改善作用。方法:将38例重症胰腺炎患者随机分为治疗组(n=19)和对照组(n=19)。对照组给予西医常规治疗,治疗组在西医治疗基础上加用清下解胰方鼻饲及灌肠治疗。在治疗24 h和72 h时,评价两组患者的急性生理与慢性健康评分-Ⅱ(APACHE-Ⅱ),检测患者的血清淀粉酶、内毒素、D乳酸水平,并比较两组患者的主要临床症状缓解情况。结果:治疗72 h时,两组患者的APACHE-Ⅱ评分均显著降低(P<0.05),且治疗组患者的评分低于对照组(P<0.05);两组患者的血清淀粉酶水平均显著降低(P<0.05),且治疗组患者的血清淀粉酶水平低于对照组(P<0.05);治疗组患者的血清内毒素、D乳酸水平均显著降低(P<0.05),且显著低于对照组(P<0.05)。治疗24 h时,治疗组中腹痛减轻患者的例数明显多于对照组(P<0.05);治疗72 h时,治疗组中腹痛减轻、腹胀缓解、排便恢复患者的例数明显多于对照组(P<0.05)。结论:清下解胰方结合西医常规治疗能够明显改善重症胰腺炎患者的临床症状,并对患者的肠屏障功能具有一定的保护作用。更多还原

【Abstract】 Objective: To explore the effect of"Qingxia Jieyi Decoction"on the intestinal barrier in patients with severe acute pancreatitis( SAP). Methods: Thirty-eight patients with SAP were randomly divided into treatment group( n = 19) and control group( n = 19). The patients in the control group were treated by conventional western medicine,and the patients in the treatment group were added with"Qingxia Jieyi Decoction"through nasogastric feeding and coloclyster. At 24 h and 72 h posttreatment,the Acute Physiology and Chronic Health Evaluation-Ⅱ( APACHE-Ⅱ) scores were assessed,the levels of serum amylase,endotoxin and D-lactic acid were detected,and the improvement of the main clinical symptoms was observed.Results: At 72 h post-treatment,the APACHE-Ⅱscores in both groups were obviously decreased( P < 0. 05),and the scores of treatment group were lower than those of the control group( P < 0. 05); the level of serum amylase in both groups was significantly decreased( P < 0. 05),and the level of serum amylase of treatment group was lower than that of the control group( P < 0. 05); the levels of serum endotoxin and D-lactic acid of treatment group were markedly decreased( P < 0. 05),and were lower than those of the control group( P < 0. 05). At 24 h post-treatment,the number of the cases whose abdominal pain relieved in the treatment group was more than that in the control group( P < 0. 05); at 72 h post-treatment,the numbers of the cases whose abdominal pain relieved,abdominal distention improved or defecation recovered in the treatment group were more than those in the control group( P < 0. 05). Conclusion: "Qingxia Jieyi Decoction "combined with western medicine can improve the clinical symptoms and protect the intestinal barrier for patients with SAP.更多还原