目的:探討早期采用益活清下法治療重癥急性胰腺炎(severe acute pancreatitis,SAP)并腎功能不全的療效。方法:35 例符合病例選擇標(biāo)準(zhǔn)并接受益活清下法治療的SAP并發(fā)腎功能不全患者,按發(fā)病后入院時(shí)間分為早期組(3d 內(nèi)入院接受治療,24例)和晚期組(3～7 d 內(nèi)入院接受治療,11例),比較治療過程中兩組患者各并發(fā)癥的持續(xù)時(shí)間、病程、手術(shù)中轉(zhuǎn)率及病死率。結(jié)果:兩組入院48小時(shí)Ranson 評分、急性生理和慢性健康評價(jià)指標(biāo)Ⅱ(APACHE Ⅱ )評分及CT 評分比較差異無顯著性(Pgt; 0.05);早期組急性呼吸窘迫綜合征、腎功能不全的持續(xù)時(shí)間低于晚期組(Plt; 0.05);早期組和晚期組中轉(zhuǎn)手術(shù)率分別12.5%(3/24例)和 18.18%(2/11例),差異無統(tǒng)計(jì)學(xué)意義(Pgt; 0.05);病死率早期組和晚期組分別為 8.33%(2/24例)和9.09%(1/11例),差異無統(tǒng)計(jì)學(xué)意義(Pgt; 0.05);早期組和晚期組住院病程分別為(20.40±18.25)d 和(34.92±12.62)d,兩組比較有統(tǒng)計(jì)學(xué)意義(Plt; 0.05)。結(jié)論:早期使用益活清下法對SAP合并腎功能不全可以取得更好療效。
摘要:目的: 探討益活清下法治療重癥急性胰腺炎(severe acute pancreatitis, SAP)對血清單核趨化蛋白1及對器官功能不全的影響。 方法 : 依據(jù)納入和排除標(biāo)準(zhǔn),選取SAP患者24例,按1︰1隨機(jī)分為治療組和對照組,在接受相同西醫(yī)治療的基礎(chǔ)上,治療組使用中藥“益活清下”法治療,對照組同時(shí)接受中藥安慰劑治療。測定患者第0、1、3、5、7天血清MCP1的濃度水平,比較各器官功能不全的發(fā)生率與持續(xù)時(shí)間。 結(jié)果 :兩組入院時(shí)Rason評分、CT評分、急性生理和慢性健康評價(jià)指標(biāo)Ⅱ評分無統(tǒng)計(jì)學(xué)差異(〖WTBX〗P gt;005)。對照組第3天MCP1濃度水平明顯高于治療組,差異有統(tǒng)計(jì)學(xué)意義(〖WTBX〗P lt;005),對照組腸、肝功能不全的發(fā)生率高于治療組,持續(xù)時(shí)間長于治療組,但無統(tǒng)計(jì)學(xué)差異(〖WTBX〗P gt;005)。 結(jié)論 :益活清下法治療重癥急性胰腺炎,可降低患者血清MCP1的水平。Abstract: Objective: To investigated the impact of Yihuo Qingxia method on the serum monocyte chemoattractant protein1 of severe acute pancreatitis (SAP)and on the organs disfunction. Methods : Twentyfour SAP patients who admitted to hospital within 72h after onset were randomized into treatment group (n=12) and control group (n=12). The patients in the treatment group were treated by Yihuo Qingxia method, and the control group were administrated with placebo.The level of the serum mcp1 of the patients on the first,3rd,5th,7thday were measured, as well as the incidence and the duration of disfunction of the organs were compared.〖WTHZ〗Results :There were no statistical significance in admission Rason scores, CT scores, Acute physiology and chronic health evaltionⅡscores(APACHEⅡscores)(Pgt;005). The level of the serum Monocyte chemoattractant protein1 of the treatment group was lower than that of the placebo group generally(Plt;005).At the 3rd day after onset,the serum mcp1 level of the control group was significantly higher than that of the treament group(Plt;005).The incidence of the control group of the intestin disfunction and hepatic inadequacy was obviously higher than those of the treatment group,and the duration of the former was longer than that of the latter,but with no satistical significance. Conclusion :Yihuo Qingxia method can effectively cut down the level of the serum mcp1 of severe pancreatitis patients.