目的：观察柴芩承气汤治疗重症急性胰腺炎(SAP)并发麻痹性肠梗阻 (Paralytic Intestinal Obstruction)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比例随机分成试验组(20例)和对照组(20例),试验组入院时即给予柴芩承气汤灌肠治疗,对照组使用安慰剂灌肠治疗;两组入院时基线资料差异无统计学意义(Pgt;005)，且两组均给予相同常规西医治疗。观察入院后其首次自行排便排气时间,入院时、入院后第3天、第7天APACHEⅡ评分及住院病程。结果:入院后首次自行排便排气时间试验组（302±154）天,低于对照组（453±241）天;入院后第3天APACHEⅡ评分试验组（925±184）分，低于对照组（1163±222）分;入院后第7天APACHEⅡ评分试验组（624±247）分，低于对照组（881±325）分。住院时间试验组（2453±426）天,低于对照组（3032±589）天。结论:早期应用柴芩承气汤灌肠治疗SAP并发麻痹性肠梗阻,可缩短麻痹性肠梗阻的持续时间及减轻其危害,减少住院病程。
目的:观察中西医结合综合治疗重症急性胆源性胰腺炎(SABP)的效果。方法:回顾性分析四川大学华西医院2004年1月至2007年8月收治的85例SABP患者在给予禁食、胃肠减压、补液、预防及治疗感染、维持内环境、营养支持、抑制胃肠和胰液的分泌治疗的基础上给予中药柴芩承气汤经口入或保留灌肠导泻,观察这些患者的治疗效果。结果:85例SABP患者经过中西医结合内科保守治疗后58名痊愈,14例患者症状缓解出院。5例患者死亡,8例患者治疗无效,无效率为15.3%,死亡率为5.9%。结论:中西医结合方法治疗SABP患者可明显提高治疗效果及降低死亡率。
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)伴多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)的临床疗效。方法:88例符合病例选择标准并接受柴芩承气汤治疗的SAP伴MODS住院患者,按院外病程长短分为早期组(48 h内入院接受治疗,44例)和晚期组(48～72 h内入院接受治疗,44例),比较治疗过程中两组患者器官功能障碍持续时间、住院时间、感染率、中转手术率及病死率。结果:早期组急性呼吸窘迫综合征、肾功能衰竭、心功能衰竭、肝功能不全、脑病、凝血系统损害的持续时间低于晚期组(Plt;0.05);早期组住院时间、感染率、中转ICU率、中转手术率及病死率低于晚期组(Plt;0.05)。结论:早期应用柴芩承气汤治疗SAP伴MODS能减少器官损害持续时间,减轻器官损害,从而缩短病程,减少后期感染率及中转手术率,降低病死率。
Objective To investigate the effect of chaiqin chengqi decoction (CQCQD) on serum lipid metabolism in experimental acute pancreatitis. Methods A total of 27 C57BL/6 mice were randomly divided into three groups (n=9 for each group). The mice in the acute pancreatitis model group (AP group) and the acute pancreatitis model + CQCQD treatment group (APQ group) received seven intraperitoneal injections of cerulein (50 µg/kg) at hourly intervals, while the mice in the control group (CON group) received phosphate-buffered saline injections at the same regimen of cerulein. Oral gavage of CQCQD (5.5 g/kg) or same volume of distilled water was commenced 1 h after the first cerulein injection for three times at intervals of 4 h for the APQ group and AP group, respectively. Animals were sacrificed 12 h after the first cerulein / phosphate-buffered saline injection for collecting serum and tissue samples. The levels of serum lipase and amylase, pancreatic histopathology assessment, as well as pancreatic myeloperoxidase activity, were used to assess the severity of acute pancreatitis and the efficacy of CQCQD. Additionally, serum lipid metabolites were analyzed in all groups. Results In comparison to the CON group, the mice in the AP group exhibited significant edema, inflammatory cell infiltration, necrosis of pancreatic tissues, as well as elevated levels of serum amylase, lipase, and pancreatic myeloperoxidase activity (P<0.05); in comparison to the AP group, inflammatory cell infiltration and necrosis of pancreatic tissue, as well as elevated level of serum amylase significantly reduced in the APQ group (P<0.05). A total of 319 lipid molecules were identified in serum, and 13 lipid metabolites were significantly increased in the AP group and successfully decreased in the APQ group, of which 9 were lyso-phosphatidylethanolamine (LPE) molecules involved in the glycerol phospholipid metabolic pathway. Further statistical analysis revealed that six of these LPE molecules could serve as potential biomarkers. Conclusions CQCQD ameliorated pancreatic injury and serum lipid metabolism disorder of acute pancreatitis model induced by cerulein and significantly improved the abnormal increase of serum LPE level. However, the role of LPE in acute pancreatitis and the underlying mechanisms of CQCQD on LPE metabolic pathways still need further study.