本文關(guān)鍵詞： 生大黃 灌腸 急性胰腺炎 淀粉酶 炎癥因子　出處：《遼寧中醫(yī)雜志》2017年05期 　論文類型：期刊論文

【摘要】：目的:探討生大黃灌腸輔助治療急性胰腺炎的臨床療效及對(duì)淀粉酶與炎性炎癥因子的影響。方法:選擇2014年4月—2016年4月本院接診的150例急性胰腺炎患者作為本次研究對(duì)象,通過隨機(jī)數(shù)表法分為觀察組和對(duì)照組,各75例。對(duì)照組給予常規(guī)治療,觀察組在對(duì)照組基礎(chǔ)上加上生大黃灌腸輔助治療。比較兩組患者臨床癥狀恢復(fù)時(shí)間,實(shí)驗(yàn)室指標(biāo)、腫瘤壞死因子(TNF-α)、白細(xì)胞介素(IL-6)、C反應(yīng)蛋白(hs-CRP)的變化,并評(píng)價(jià)臨床療效。結(jié)果:治療后,觀察組在腹痛、腹脹,排便,腹部壓痛,腸鳴音恢復(fù)時(shí)間上均比對(duì)照組短[(3.45±0.84)d vs(4.87±1.21)d,(2.56±0.45)d vs(4.23±1.13)d,(4.52±0.93)d vs(5.34±1.24)d,(2.34±0.42)d vs(3.84±0.78)d],住院時(shí)間短于對(duì)照組[(10.23±2.31)d vs(15.18±2.74)d](P0.05);兩組患者在第3天開始,腹腔內(nèi)壓水平得到明顯下降,觀察組在3d、4 d、5 d、6 d時(shí),腹腔內(nèi)壓水平均比對(duì)照組低[(13.41±2.85)vs(14.59±3.15),(7.65±1.23)vs(12.93±1.54),(7.28±1.35)vs(10.39±1.20),(6.42±1.15)vs(8.03±1.06)](P0.05);觀察組血清淀粉酶、血尿素氮、血細(xì)胞水平均低于對(duì)照組,血鈣水平高于對(duì)照組[(205.89±42.30)U/L vs(294.74±70.41)U/L,(11.34±1.23)mmol/L vs(15.84±1.78)mmol/L,(11.34±1.68)×10~9L~(-1)vs(14.58±1.82)×10~9L~(-1),(2.19±0.12)mmol/L vs(1.84±0.15)mmol/L](P0.05);在炎癥因子中,觀察組TNF-α、IL-6、hs-CRP水平均比對(duì)照組低[(41.23±7.53)ng/L vs(58.12±10.65)ng/L,(23.12±4.57)μg/L vs(38.45±8.35)μg/L,(32.12±8.51)mg/L vs(39.84±9.42)mg/L](P0.05);觀察組治療后總有效率明顯比對(duì)照組高[93.33%(70/75)vs77.33%(58/75)](P0.05)。結(jié)論:在急性胰腺炎患者中給予生大黃灌腸輔助治療效果顯著,可有效改善患者體內(nèi)淀粉酶及炎癥因子的表達(dá),緩解病情,值得應(yīng)用推廣。
[Abstract]:Objective: to investigate the clinical effect of rhubarb enema on acute pancreatitis and its effect on amylase and inflammatory cytokines. Methods: 150 patients with acute pancreatitis were selected from April 2014 to April 2016. The observation group was divided into observation group and control group with 75 cases each. The control group was given routine treatment, the observation group was treated with rhubarb enema on the basis of the control group, and the clinical symptom recovery time and laboratory index were compared between the two groups. Changes of TNF- 偽, IL-6, IL-6, C-reactive protein hs-CRP, and evaluation of clinical efficacy. Results: after treatment, the observation group was treated with abdominal pain, abdominal distension, defecation, abdominal tenderness, abdominal tenderness, abdominal distension, abdominal tenderness. The recovery time of bowel sounds was shorter than that of the control group [3.45 鹵0.84d vs(4.87 鹵1.21d vs(4.87 鹵0.45d vs(4.23 鹵1.13d vs(5.34 4.52 鹵1.24d vs(5.34 鹵0.78d], and the hospitalization time was shorter than that of the control group [10.23 鹵2.31d vs(15.18 鹵2.74d] P0.050.The patients in both groups had a significant decrease in intraperitoneal pressure on the 3rd day, and the patients in the observation group had a significant decrease in the level of intraperitoneal pressure on the 3rd day after 4 days, 5 days after 6 days, and the duration of hospitalization was less than that in the control group [10.23 鹵2.31 days, vs(15.18 鹵2.74 days], and the levels of intraperitoneal pressure in the two groups were significantly lower than those in the control group on the 3rd day, 4 days, 5 days, 6 days after treatment, and the duration of hospitalization was less than that of the control group. The level of intraperitoneal pressure was lower than that of the control group (13.41 鹵2.85 vs 14.59 鹵3.15v / L 7.65 鹵1.23V / L 12.93 鹵1.545.28 鹵1.35v / s = 10.39 鹵1.20v / s 8.03 鹵1.06respectively); the levels of serum amylase and blood urea nitrogen in the observation group were all lower than those in the control group, and the serum calcium level was higher than that in the control group [205.89 鹵42.30U / L vs(294.74 鹵70.41U / L vs(294.74 鹵70.41U / mol / L = 11.34 鹵1.23mmol / L vs(15.84 鹵1.78mmol / L] 109L- 1s14.58 鹵1.81010L-1 / L + 0.151mmol 鹵0.151mmol 鹵0.151mmol / L; The levels of IL-6hs-CRP in the observation group were lower than those in the control group [41.23 鹵7.53ng / L vs(58.12 鹵10.65ng / L vs(58.12 鹵10.65ng / L] 渭 g / L vs(38.45 鹵8.35 渭 g / L vs(38.45 鹵8.35 渭 g / L respectively. Conclusion: the effect of adjuvant treatment with rhubarb was significant in patients with acute pancreatitis, and the total effective rate in the observation group was significantly higher than that in the control group [93.337075v / s 77.3358 / 75]. Can effectively improve the expression of amylase and inflammatory factors in patients, ease the disease, worthy of application and promotion.
【作者單位】： 儋州市人民醫(yī)院消化內(nèi)科;
【分類號(hào)】：R576

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