CAJ | 학술논문

目的探讨分期辩证论治结合肠内营养治疗重症急性胰腺炎(sever acute pancreatitis, SAP)的临床疗效。方法回顾性分析我院2007年1月~2012年8月间收治的82例SAP患者的临床资料，其中经常规中西医结合治疗（对照组）42例，分期辩证论治结合肠内营养（治疗组）40例。结果治疗组1w Balthaza CT评分为(4.4±1.3)，1w APACHEⅡ评分为(8.7±2.3)，血淀粉酶降至正常时间（5.1±2.6）d，肠道功能恢复时间(49±10.4)h，住院时间(46.2±10.6)d，出院时体重降低(3.6±2.1)kg，输白蛋白量(165±40.8)g，对照组对应指标为(5.2±1.5),(11.8±2.6),（7.2±1.5）d，(85±12.6)h,(64.7±6.6)d，(6.4±2.5)kg ，(246±35.5)g,两组差异有统计学意义Ρ<0.05，Ρ<0.001，Ρ<0.001，Ρ<0.001,Ρ<0.001，Ρ<0.001,Ρ<0.001。治疗组严重并发症发生率30.0%（12/40），严重腹胀发生率20.0%（8/40），对照组对应指标54.8%（23/42）,40.5%（17/42），两组差异均有统计学意义Ρ<0.05。治疗组手术干预率5.0%（2/40），死亡率7.5%(3/40),对照组19.0%（8/42），21.4%（9/42），两组差异均无统计学意义Ρ>0.05。结论分期辩证论治结合肠内营养治疗SAP能提高患者恢复质量，降低严重并发症发生率，疗效总体优于常规中西医结合治疗。
목적탐토분기변증론치결합장내영양치료중증급성이선염(sever acute pancreatitis, SAP)적림상료효。방법회고성분석아원2007년1월~2012년8월간수치적82례SAP환자적림상자료，기중경상규중서의결합치료（대조조）42례，분기변증론치결합장내영양（치료조）40례。결과치료조1w Balthaza CT평분위(4.4±1.3)，1w APACHEⅡ평분위(8.7±2.3)，혈정분매강지정상시간（5.1±2.6）d，장도공능회복시간(49±10.4)h，주원시간(46.2±10.6)d，출원시체중강저(3.6±2.1)kg，수백단백량(165±40.8)g，대조조대응지표위(5.2±1.5),(11.8±2.6),（7.2±1.5）d，(85±12.6)h,(64.7±6.6)d，(6.4±2.5)kg ，(246±35.5)g,량조차이유통계학의의Ρ<0.05，Ρ<0.001，Ρ<0.001，Ρ<0.001,Ρ<0.001，Ρ<0.001,Ρ<0.001。치료조엄중병발증발생솔30.0%（12/40），엄중복창발생솔20.0%（8/40），대조조대응지표54.8%（23/42）,40.5%（17/42），량조차이균유통계학의의Ρ<0.05。치료조수술간예솔5.0%（2/40），사망솔7.5%(3/40),대조조19.0%（8/42），21.4%（9/42），량조차이균무통계학의의Ρ>0.05。결론분기변증론치결합장내영양치료SAP능제고환자회복질량，강저엄중병발증발생솔，료효총체우우상규중서의결합치료。
Objective To investigate the clinical therapeutic effect of severe acute pancreatitis treated by four feasibility of dialectical analysis and summary of traditional Chinese medicine combined with enteral nutrition.Methods To analyze the clinical data of the 82 SAP patients retrospectively in our hospital from January 2007 to August 2012, 40 in the treat group were treated by four feasibility of dialectical analysis and summary of traditional Chinese medicine combined with enteral nutrition, and 42 in the control group were treated by the traditional combination of TCM and western medicine therapy. Results In the treat group, after 1 week Bathazar CT score (4.4±1.3), after 1 week the APACHEⅡ score was 8.7±2.3, the time of AMY drop to normal (5.1±2.6)days, the intestinal function recovery time (49±10.4)h, the length of stay (46.2±10.6) days ,the weight loss in discharge3.6±2.1kg, the albumin input quantity165±40.8g , and those in the control group were (5.2±1.5), (11.8±2.6),(7.2±1.5)d,(85±12.6)h, (64.7± 6.6)d,(6.4±2.5)kg,(246±35.5)g, The differences between the treat group and the control group were statistical significance,Ρ<0.05,Ρ<0.01,Ρ<0.001,Ρ<0.001, Ρ<0.001,Ρ<0.001, Ρ<0.001. The severe complication30.0%(12/40), severe abdominal distension 20.0%(8/40),and those in the control group were54.8%(23/42), 40.5%(17/42),The differences between the treat group and the control group were statistical significance,Ρ<0.05. The peration intervention5.0%(2/40), the fatality7.5%(3/40), and those in the control group were19.0%(8/42),21.4%(9/42),The differences between the treat group and the control group were not statistical significance,Ρ>0.05. Conclusion The four feasibility of dialectical analysis and summary of traditional Chinese medicine combined with enteral nutrition can shorten the time of hemodiastase drop to normal, the intestinal function recovery time ,shorten the time of stay, cut down 1 week the APACHEⅡ score and after 1 weeks Bathazar CT score, cut down the albumin input quantity ,the weight loss in discharge, cut down the operation severe complication and the severe abdominal distension. The curative effect surpass the traditional combination of TCM and western medicine therapy.