目的:探讨早期采用益活清下法治疗重症急性胰腺炎(severe acute pancreatitis,SAP)并肾功能不全的疗效。方法:35 例符合病例选择标准并接受益活清下法治疗的SAP并发肾功能不全患者,按发病后入院时间分为早期组(3d 内入院接受治疗,24例)和晚期组(3～7 d 内入院接受治疗,11例),比较治疗过程中两组患者各并发症的持续时间、病程、手术中转率及病死率。结果:两组入院48小时Ranson 评分、急性生理和慢性健康评价指标Ⅱ(APACHE Ⅱ )评分及CT 评分比较差异无显著性(Pgt; 0.05);早期组急性呼吸窘迫综合征、肾功能不全的持续时间低于晚期组(Plt; 0.05);早期组和晚期组中转手术率分别12.5%(3/24例)和 18.18%(2/11例),差异无统计学意义(Pgt; 0.05);病死率早期组和晚期组分别为 8.33%(2/24例)和9.09%(1/11例),差异无统计学意义(Pgt; 0.05);早期组和晚期组住院病程分别为(20.40±18.25)d 和(34.92±12.62)d,两组比较有统计学意义(Plt; 0.05)。结论:早期使用益活清下法对SAP合并肾功能不全可以取得更好疗效。
摘要:目的: 探讨益活清下法治疗重症急性胰腺炎(severe acute pancreatitis, SAP)对血清单核趋化蛋白1及对器官功能不全的影响。 方法 : 依据纳入和排除标准,选取SAP患者24例,按1︰1随机分为治疗组和对照组,在接受相同西医治疗的基础上,治疗组使用中药“益活清下”法治疗,对照组同时接受中药安慰剂治疗。测定患者第0、1、3、5、7天血清MCP1的浓度水平,比较各器官功能不全的发生率与持续时间。 结果 :两组入院时Rason评分、CT评分、急性生理和慢性健康评价指标Ⅱ评分无统计学差异(〖WTBX〗P gt;005)。对照组第3天MCP1浓度水平明显高于治疗组,差异有统计学意义(〖WTBX〗P lt;005),对照组肠、肝功能不全的发生率高于治疗组,持续时间长于治疗组,但无统计学差异(〖WTBX〗P gt;005)。 结论 :益活清下法治疗重症急性胰腺炎,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.