CAJ | 학술논문

目的：观察中药联合内镜介入治疗急性胆源性胰腺炎患者的临床疗效。方法将90例急性胆源性胰腺炎患者随机分成治疗组和对照组，每组45例。对照组患者给予内镜介入治疗及抗感染、抑酸、抑酶和补液，治疗组则在此基础上给予中药口服及灌肠治疗。监测两组患者的症状和体征消失时间及临床疗效、生化指标恢复时间和局部并发症发生率、转外科手术率、死亡率情况。结果治疗组患者体温恢复时间、腹痛消失时间、腹胀消失时间、恢复自主排便时间及住院时间均较对照组显著缩短，两组比较差异有统计学意义（P ﹤0.05）。治疗组血淀粉酶、尿淀粉酶、C -反应蛋白、白细胞总数、谷氨酰转肽酶、碱性磷酸酶恢复正常时间均较对照组显著缩短，差异有统计学意义（ P ﹤0.05）；血钙、总胆红素恢复正常时间与对照组相比差异无统计学意义（ P ﹥0.05）。治疗组局部并发症发生率与对照组相比显著下降，差异有统计学意义（P ﹤0.05）；转外科手术率与病死率与对照组相比，差异无统计学意义（P ﹥0.05）。治疗组痊愈率明显高于对照组，差异有统计学意义（P ﹤0.05），两组总有效率比较无明显差异。结论中药联合内镜治疗急性胆源性胰腺炎的治疗效果优于非联合中药治疗者，值得推广使用。
목적：관찰중약연합내경개입치료급성담원성이선염환자적림상료효。방법장90례급성담원성이선염환자수궤분성치료조화대조조，매조45례。대조조환자급여내경개입치료급항감염、억산、억매화보액，치료조칙재차기출상급여중약구복급관장치료。감측량조환자적증상화체정소실시간급림상료효、생화지표회복시간화국부병발증발생솔、전외과수술솔、사망솔정황。결과치료조환자체온회복시간、복통소실시간、복창소실시간、회복자주배편시간급주원시간균교대조조현저축단，량조비교차이유통계학의의（P ﹤0.05）。치료조혈정분매、뇨정분매、C -반응단백、백세포총수、곡안선전태매、감성린산매회복정상시간균교대조조현저축단，차이유통계학의의（ P ﹤0.05）；혈개、총담홍소회복정상시간여대조조상비차이무통계학의의（ P ﹥0.05）。치료조국부병발증발생솔여대조조상비현저하강，차이유통계학의의（P ﹤0.05）；전외과수술솔여병사솔여대조조상비，차이무통계학의의（P ﹥0.05）。치료조전유솔명현고우대조조，차이유통계학의의（P ﹤0.05），량조총유효솔비교무명현차이。결론중약연합내경치료급성담원성이선염적치료효과우우비연합중약치료자，치득추엄사용。
Objective To observe the effect on acute biliary pancreatitis treated with Chinese herbal medicine and endoscopic intervention. Methods Ninety cases of acute biliary pancreatitis were randomized into a treatment group and a control group,45 cases in each one. In the control group,the endoscopic inter-vention and the treatment of anti - infection,acid resistance,enzyme resistance and rehydration were applied. In the treatment,beside the basic treatment,the oral administration of Chinese herbal medicine and enema treatment were used. The relief time of symptoms and physical signs,clinical efficacy,recovery time of bio-chemical markers,the incidence of local complication,surgery transfer rate and death rate were monitored in the two groups. Results In the treatment group,the body temperature recovery time,abdominal pain relief time,defecation recovery time and admission time were all shorter significantly than those in the control group,indicating the significant difference(P ﹤ 0. 05). In the treatment group,the recovery time of PAMY, UAMY,CRP,WBC,GGT and AKP were shorter significantly than those in the control group,indicating the significant difference(P ﹤ 0. 05). The recovery time of blood calcium and total bilirubin was not different sig-nificantly than those in the control group(P ﹥ 0. 05). The local complication incidence in the treatment group was reduced significantly as compared with the control group,indicating the significant difference( P ﹤0. 05). The transfer rate of surgery and death rate were not different significantly between the two groups,in-dicating no significant difference(P ﹥0. 05). The curative rate in the treatment group was higher obviously than that in the control group,indicating the significant difference(P ﹤ 0. 05). But the total effective rate was not different significantly between the two groups. Conclusion The therapeutic effect of Chinese herbal medicine and endoscopic intervention was better than simple therapy without Chinese herbal medicine involved in the treatment of acute biliary pancreatitis. This combined therapy deserves to be promoted in clinical practice.