摘要
目的探讨早期应用柴芩承气汤治疗重症急性胰腺炎(severe acute pancreatitis,SAP)并发急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的疗效。方法依据纳入和排除标准,选取四川大学华西医院中西医结合科收治的SAP患者40例,按1:1比例随机分成早期治疗组(早期组,20例)和晚期治疗组(晚期组,20例),早期组入院时即给予柴芩承气汤治疗;晚期组入院3天后加用柴芩承气汤治疗;两组入院时基线资料差异无统计学意义(P>0.05)且两组均给予相同常规西医治疗。观察其第7天APACHEⅡ评分、并发症发生率及持续时间、感染发生率、手术中转率、病死率及住院病程。结果治疗第7天早期组APACHEⅡ评分(5.1±2.0)分,明显低于晚期组(9.3±4.3)分;早期组并发休克发生率为5.0%(1/20)明显低于晚期组〔36.8%(7/19)〕;早期组ARDS,肾功能衰竭,休克,心、肝功能不全,脑病及肠麻痹持续时间及住院病程均短于晚期组(P<0.05,P<0.01);早期组手术中转率低于晚期组,差异有统计学意义(P<0.05);但感染发生率和病死率差异无统计学意义(P>0.05)。结论早期应用柴芩承气汤治疗SAP,可缩短并发症的持续时间及病程,降低手术中转率,但对感染发生率和病死率的影响,有待于扩大样本量的进一步研究。
Objective To investigate the therapeutic effects of an early application of Chaiqin Chengqi Decoction （CQCQD） on severe acute pancreatitis （SAP） complicated with acute respiratory distress syndrome （ARDS）. Methods Forty patients of SAP-ARDS were equally randomized into the early-treated group （ET） and the late-treated group （ LT）, CQCQD was administered to them immediately and 3 days later after hospitalization respectively. Baseline materials in the two groups at the entry were insignificantly different （ P 〉 0.05）, and the same conventional Western medical therapy were available to them all. The Acute Physiology and Chronic Heath Evaluation Ⅱ （APACHE Ⅱ） scores, the incidence and sustained time of complications, the occurrence of infection, requirement of operation shifting on day 7, as well as the duration resided in hospital and mortality in patients were observed and compared. Results Comparisons of the above-mentioned clinical indexes between groups showed that the APACHE Ⅱ score was lower （5.1±2.0 scores vs 9.3 ＋4.3 scores, P〈0. 01） ; the incidence of shock was lesser （1/20 vs 7/19） ; the duration of ARDS, renal failure, cardiac insufficiency, hepatic dysfunction, cerebropathy and enteroplegia, as well as the duration in hospital and the requirement of operation shifting were all shorter significantly （ P 〈 0.05） in the ET group than those in the LT group, but no statistical difference （ P 〉0.05） was shown in terms of the infection incidence and the mortality. Conclusion An early application of CQCQD in the treatment of SAP could shorten the duration of complications and the couse of disease, lower the requirement of operation shifting. But further study with large samples for explore its impact on the infection incidence and the mortality is needed.
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2009年第4期322-324,共3页
Chinese Journal of Integrated Traditional and Western Medicine
关键词
重症急性胰腺炎
急性呼吸窘迫综合征
柴芩承气汤
severe acute pancreatitis
acute respiratory distress syndrome
Chaiqin Chengqi Decoction
