柴芍承气汤保留灌肠联合九合丹外敷治疗肝胃实热证急性胰腺炎的效果观察

Observation on the Effect of Retention Enema with Chaishao Chengqi Decoction Combined with External Application of Jiuhedan in the Treatment of Acute Pancreatitis with Excess Heat Syndrome of Liver and Stomach

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摘要目的探讨柴芍承气汤保留灌肠联合九合丹外敷治疗肝胃实热证急性胰腺炎的效果。方法纳入2021年7月至2022年9月收治的60例肝胃实热证急性胰腺炎患者,采用随机数字表法分为观察组和对照组各30例,对照组给予常规西药联合九合丹外敷治疗,观察组在对照组基础上联合柴芍承气汤保留灌肠治疗,均治疗7 d。治疗后比较2组临床疗效,腹胀及腹痛缓解时间、进食时间、首次排便时间、肠鸣音恢复时间与住院时间;比较2组治疗前后中医证候积分及C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血淀粉酶水平,以及2组不良反应发生情况。结果观察组总有效率为93.33%高于对照组的73.33%(P<0.05)。观察组治疗后腹胀及腹痛缓解时间、进食时间、首次排便时间、肠鸣音恢复时间与住院时间均短于对照组(P<0.01)。治疗后2组脘腹胀痛、大便黏滞不通、发热、胸闷不舒、烦渴引饮中医证候积分均下降,且观察组低于对照组(P<0.05)。治疗后2组CRP、IL-6、TNF-α、血淀粉酶均下降,且观察组低于对照组(P<0.05,P<0.01)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论柴芍承气汤保留灌肠联合九合丹外敷治疗肝胃实热证急性胰腺炎患者的效果良好,可有效减轻患者症状、促进胃肠功能恢复,降低炎性因子及血淀粉酶水平,且安全性较好。 Objective To explore the effect of retention enema with Chaishao Chengqi decoction combined with external application of Jiuhedan on acute pancreatitis with excess heat syndrome of liver and stomach.Methods A total of 60 patients with acute pancreatitis and excess heat syndrome of liver and stomach treated from July 2021 to September 2022 were included and divided into the observation group(n=30)and the control group(n=30)by random number table method.The control group was given conventional Western medicine combined with external application of Jiuhedan,and the observation group was supplemented with retention enema with Chaishao Chengqi decoction on the basis of the control group.After treatment,the clinical efficacy,relief time of abdominal distension and pain,time of food intake,first time of defecation,recovery time of bowel sound and length of hospital stay of the two groups were compared.Traditional Chinese Medicine(TCM)syndrome scores,C reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and blood amylase levels before and after treatment were compared between the two groups,as well as the occurrence of adverse reactions between the two groups.Results The total effective rate was 93.33%in the observation group and 73.33%in the control group(P<0.05).The relief time of abdominal distension and abdominal pain,time of food intake,first time of defecation,recovery time of bowel sound and length of hospital stay in the observation group were shorter than those in the control group(P<0.01).After treatment,the scores of epigastric distension and pain,sticky stool,fever,chest tightness,dyspeptic and TCM syndrome score in the two groups all decreased,which were lower in the observation group than in the control group(P<0.05).After treatment,CRP,IL-6,TNF-αand blood amylase in the two groups were decreased,which were lower in the observation group than in the control group(P<0.05,P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Retention enema with Chaishao Chengqi decoction combined with external application of Jiuhedan has a good effect on acute pancreatitis with excess heat syndrome of liver and stomach,which can effectively reduce the symptoms of patients,promote the recovery of gastrointestinal function,reduce inflammatory factors and blood amylase levels,and has good safety.

作者李丹丹王明选沈小程潘金王春微 LI Dandan;WANG Mingxuan;SHEN Xiaocheng;PAN Jin;WANG Chunwei(Department of Traditional Chinese Medicine,Suining Central Hospital,Suining,Sichuan 629000,China)

机构地区遂宁市中心医院中医科

出处《临床误诊误治》 2025年第2期72-76,共5页 Clinical Misdiagnosis & Mistherapy

基金 2022年度市级中医药科研专项课题(SN2022B14)。

关键词急性胰腺炎肝胃实热证柴芍承气汤九合丹 C反应蛋白白细胞介素-6 淀粉酶药物毒性 Acute pancreatitis Excess heat syndrome of liver and stomach Chaishao Chengqi decoction Jiuhedan C reactive protein Interleukin-6 Amylase Drug toxicity

分类号 R576 [医药卫生—消化系统]

作者简介李丹丹,硕士研究生,主治医师。主要从事中医胰腺炎方向研究;通讯作者:王春微,E-mail:370014507@qq.com。