复方大承气汤灌肠联合芒硝外敷治疗急性胰腺炎临床观察

目的 观察复方大承气汤联合芒硝外敷治疗急性胰腺炎的临床疗效。方法 将107例急性胰腺炎患者随机分为观察组（54例）和对照组（53例），对照组给予西医综合保守治疗，观察组在对照组基础上加用复方大承气汤灌肠联合中药芒硝外敷，观察两组患者治疗前后炎症水平，血清淀粉酶（amylase， AMY）、电解质变化，胰腺影像学变化，临床症状消失时间和并发症情况。结果 与治疗前比较，两组患者治疗后白细胞、中性粒细胞计数，C- 反应蛋白（C- reactive protein，CRP）、AMY水平均显著降低（P＜0.05），K+、Na+、Cl-、Ca2+、HCO3-水平均显著升高（P＜0.05）；观察组患者白细胞、中性粒细胞计数，CRP、AMY水平降低程度和血清Ca2+、HCO3-水平升高程度均显著大于对照组（P＜0.05）；观察组患者胰腺肿胀、胰腺周围渗出程度均显著低于对照组（P＜0.05）；观察组总并发症发生率为1.85%，明显低于对照组的15.09%（P＜0.05）；观察组患者腹痛、腹胀消失时间，肠鸣音恢复时间，恢复进食时间，住院时间均较对照组显著缩短（P＜0.05）。结论 在西医综合治疗的基础上联合中医药治疗，能够提高急性胰脉炎的治疗效果，同时减少并发症发生并缩短疗程。

Clinical Effect of Enema with Compound Dachengqi Decoction Combined with External Application of Mirabilite in Treatment of Acute Pancreatitis

Objective To investigate the clinical effect of compound Dachengqi Decoction combined with external application of mirabilite in the treatment of acute pancreatitis. Methods A total of 107 patients with acute pancreatitis were randomly divided into observation group with 54 patients and control group with 53 patients. The patients in the control group were given comprehensive Western medicine conservative treatment, and those in the observation group were given enema with compound Dachengqi Decoction combined with external application of the traditional Chinese medicine mirabilite in addition to the treatment in the control group. The two groups were compared in terms of the changes in inflammation level, serum amylase (AMY), electrolytes, and pancreatic imaging findings after treatment, as well as time to the disappearance of clinical symptoms and complications. Results After treatment, both groups had significant reductions in white blood cell count, neutrophil count, C- reactive protein (CRP), and AMY (P<0.05) and significant increases in the levels of K+, Na+, Cl-, Ca2+, and HCO3- (P<0.05). Compared with the control group, the observation group had significantly greater reductions in white blood cell count, neutrophil count, CRP, and AMY and significantly greater increases in the serum levels of Ca2+ and HCO3-(P<0.05). The observation group had significantly lower degrees of swelling of the pancreas and peripancreatic effusion than the control group (P<0.05). The observation group had a significantly lower overall incidence rate of complications than the control group (1.85% vs 15.09%,P<0.05). Compared with the control group, the observation group had significantly shorter time to the disappearance of abdominal pain and abdominal distension, time to first bowel sound, time to diet, and length of hospital stay (P<0.05). Conclusion Traditional Chinese medicine treatment combined with comprehensive Western medicine treatment can improve the treatment outcome of acute pancreatitis, reduce the incidence rate of complications, and shorten the course of treatment.