通腑清胰湯治療急性胰腺炎的臨床療效觀察
發(fā)布時間：2019-01-16 05:30
【摘要】：目的本次臨床實驗將符合輕度急性胰腺炎標(biāo)準(zhǔn),同時中醫(yī)辨證為腹痛腑實熱結(jié)證的患者作為研究對象,采用通腑清胰湯灌腸,客觀地評價通腑清胰湯治療急性胰腺炎的臨床療效及安全性,用以指導(dǎo)臨床實踐。方法1.病例來源選取2014年10月至2016年1月就診于山西陽煤集團總醫(yī)院消化內(nèi)科的住院患者,收集符合本次研究標(biāo)準(zhǔn)病例60例,依據(jù)隨機原則,將其納入實驗組和對照組各30例。兩組給予同等西醫(yī)綜合治療,對照組給予無菌水灌腸;實驗組加用通腑清胰湯灌腸,兩組用藥時間及方法要求一致。分析記錄兩組患者治療前后臨床療效評分,中醫(yī)癥狀積分,腸功能積分情況,血清淀粉酶以及治療前后1周CT分級改變,住院時間,比較兩組療效。2.本方組成:柴胡30g,黃芩20g,生白芍30g,太子參20g,半夏10g,枳實30g,厚樸30g,生大黃50g,玄明粉50g,梔子20g,黃連10g,佛手20g,吳茱萸10g,烏藥20g,木香20g,玄參30g,生甘草3g。每副方藥熬制濃縮400ml湯劑,每日早晚各1次,每次200ml,保留灌腸。結(jié)果臨床綜合療效比較:兩組總體有效率之間無明顯差異(P㧐0.05),但實驗組治愈顯效率明顯優(yōu)于對照組(P0.05)。中醫(yī)癥候積分比較:兩組治療第5天癥狀較前均有明顯改善(P㩳0.05),其中主癥方面實驗組與對照組之間具有明顯差異(P㩳0.01);腸功能評分比較:兩組治療后腸功能均有顯著改善(P㩳0.01),但實驗組明顯優(yōu)于對照組(P㩳0.05)。治療前后腹部CT比較:兩組均有明顯改善,但兩組間無明顯差異(P㧐0.05)。實驗室指標(biāo):血淀粉酶恢復(fù)天數(shù)兩組之間無明顯差異。住院天數(shù)兩組之間有統(tǒng)計學(xué)差異(P㩳0.05),且實驗組住院時間更短。結(jié)論通腑清胰湯在緩解輕度急性胰腺炎早期(急性期)腑實熱結(jié)證患者的腹痛腹脹等癥狀方面效果較為明顯,說明通腑清胰湯治療急性胰腺炎療效確切。本研究開闊了急性胰腺炎治療的新思路,為臨床治療急性胰腺炎提供理論依據(jù),從而進一步改善并提高患者的生存質(zhì)量,具有巨大的社會效益和經(jīng)濟效益。
[Abstract]:Objective to use Tongfu Qingyi decoction (Tongfu Qingyi decoction) to enema the patients who accord with the standard of mild acute pancreatitis and syndrome differentiation of traditional Chinese medicine (TCM) for abdominal pain and solid heat. Objective to evaluate the clinical efficacy and safety of Tongfu Qingyi decoction for guiding clinical practice. Method 1. From October 2014 to January 2016, 60 cases were collected from the Department of Digestive Medicine, Shanxi Yang Coal Group General Hospital. According to the random principle, they were included in the experimental group and the control group respectively. The two groups were given the same comprehensive western medicine treatment, the control group was given aseptic water enema, the experimental group was given Tongfu Qingyi decoction enema, the two groups used the same time and method. The clinical curative effect score, TCM symptom score, intestinal function score, serum amylase, CT grading and hospitalization time before and after treatment were recorded and compared between the two groups. 2. Composition: Bupleurum 30g, Scutellaria baicalensis 20g, Radix Paeoniae Alba 30g, Radix Pseudostellariae princeliae 20g, Pinellia ternata 10g, Fructus Aurantii 30g, Magnolia officinalis 30g, rhubarb 50g, Gardenia 20g, Coptis chinensis 10g, Buddha's hand 20g, Evodiae officinalis 10g, Radix Umbiae 20g, Muxiang 20g, Radix Xuanshen 30g. Licorice 3 g. Each prescription to make concentrated 400ml decoction, every morning and evening, 200 ml, retention enema. Results there was no significant difference in the total effective rate between the two groups (P0. 05), but the effective rate of the experimental group was significantly better than that of the control group (P0.05). Comparison of TCM symptom score: the symptoms of the two groups were significantly improved on the 5th day after treatment (P0. 05), and there was a significant difference between the experimental group and the control group in the main symptoms (P0. 01). Comparison of intestinal function score: after treatment, the intestinal function of the two groups were significantly improved (P0. 01), but the experimental group was significantly better than the control group (P0. 05). Comparison of abdominal CT before and after treatment: there was significant improvement in both groups, but there was no significant difference between the two groups (P0. 05). Laboratory index: there was no significant difference between the two groups in the days of blood amylase recovery. There was statistical difference between the two groups (P0. 05), and the time of hospitalization in the experimental group was shorter than that in the control group. Conclusion Tongfu Qingyi decoction is more effective in relieving abdominal pain and abdominal distention in patients with mild acute pancreatitis in early stage (acute phase), indicating that Tongfu Qingyi decoction is effective in treating acute pancreatitis. This study broadens the new thinking of treatment of acute pancreatitis, and provides theoretical basis for clinical treatment of acute pancreatitis, thus further improving and improving the quality of life of patients, with great social and economic benefits.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
[Abstract]:Objective to use Tongfu Qingyi decoction (Tongfu Qingyi decoction) to enema the patients who accord with the standard of mild acute pancreatitis and syndrome differentiation of traditional Chinese medicine (TCM) for abdominal pain and solid heat. Objective to evaluate the clinical efficacy and safety of Tongfu Qingyi decoction for guiding clinical practice. Method 1. From October 2014 to January 2016, 60 cases were collected from the Department of Digestive Medicine, Shanxi Yang Coal Group General Hospital. According to the random principle, they were included in the experimental group and the control group respectively. The two groups were given the same comprehensive western medicine treatment, the control group was given aseptic water enema, the experimental group was given Tongfu Qingyi decoction enema, the two groups used the same time and method. The clinical curative effect score, TCM symptom score, intestinal function score, serum amylase, CT grading and hospitalization time before and after treatment were recorded and compared between the two groups. 2. Composition: Bupleurum 30g, Scutellaria baicalensis 20g, Radix Paeoniae Alba 30g, Radix Pseudostellariae princeliae 20g, Pinellia ternata 10g, Fructus Aurantii 30g, Magnolia officinalis 30g, rhubarb 50g, Gardenia 20g, Coptis chinensis 10g, Buddha's hand 20g, Evodiae officinalis 10g, Radix Umbiae 20g, Muxiang 20g, Radix Xuanshen 30g. Licorice 3 g. Each prescription to make concentrated 400ml decoction, every morning and evening, 200 ml, retention enema. Results there was no significant difference in the total effective rate between the two groups (P0. 05), but the effective rate of the experimental group was significantly better than that of the control group (P0.05). Comparison of TCM symptom score: the symptoms of the two groups were significantly improved on the 5th day after treatment (P0. 05), and there was a significant difference between the experimental group and the control group in the main symptoms (P0. 01). Comparison of intestinal function score: after treatment, the intestinal function of the two groups were significantly improved (P0. 01), but the experimental group was significantly better than the control group (P0. 05). Comparison of abdominal CT before and after treatment: there was significant improvement in both groups, but there was no significant difference between the two groups (P0. 05). Laboratory index: there was no significant difference between the two groups in the days of blood amylase recovery. There was statistical difference between the two groups (P0. 05), and the time of hospitalization in the experimental group was shorter than that in the control group. Conclusion Tongfu Qingyi decoction is more effective in relieving abdominal pain and abdominal distention in patients with mild acute pancreatitis in early stage (acute phase), indicating that Tongfu Qingyi decoction is effective in treating acute pancreatitis. This study broadens the new thinking of treatment of acute pancreatitis, and provides theoretical basis for clinical treatment of acute pancreatitis, thus further improving and improving the quality of life of patients, with great social and economic benefits.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
【參考文獻】
相關(guān)期刊論文 前10條
1 金琦;蔡天蕊;黃朔;何其勇;孫玉鴻;;黃芩對急性重癥胰腺炎大鼠肝損傷的預(yù)防及治療作用研究[J];中國現(xiàn)代醫(yī)學(xué)雜志;2016年01期
2 李君儀;竹林;向瑾;趙健蕾;李娟;郭徽;唐文富;;大承氣湯主要成分在急性胰腺炎大鼠的組織分布特征[J];中國實驗方劑學(xué)雜志;2016年01期
3 蔣圣早;屈臘元;高超;;中西醫(yī)結(jié)合治療對急性胰腺炎病程的影響[J];中國衛(wèi)生標(biāo)準(zhǔn)管理;2015年13期
4 吳t熮，
本文編號：2409517
本文鏈接：http://sikaile.net/zhongyixuelunwen/2409517.html
最近更新
教材專著
