| Objective:Acute pancreatitis is one of the acute abdominal diseases, the incidence rate of acute pancreatitis is about 4.8-24 cases/10 million,20%-30% patients are severe acute pancreatitis with severe illness, the death rate of which is about 5%-10%. For some complex conditions of pancreatitis, in particular, associating with intestinal paralysis is more severe, doctors with western medicine often take passive measures,but do not receive satisfactory effect. Chinese herb doctors often take active measures by removing stagnant food in the intestines and relieving constipation by purgation. Da Chai Hu Decoction is commonly used as the basic treatment of acute pancreatitis with intestinal paraly sis, show-ing a good clinical efficacy. However, the acute pancreatitis complicated, especially associating with more severe cases of intestinal paralysis, the basic decoction is still not satisfied, this research tried to explore the curative method of combining Chinese and Western Medicine treating acute pancreatitis associating with more serious intestinal paralysis to observe the effects and possible mechanism.Methods:60 acute pancreatitis cases with intestinal paralysis were randomly divided into two groups, treating group with 30 cases and controlling group with 30 patients. Two groups were all given Western medicine treatment, including fasting, continuous gastrointestinal decompression, antiinflam-matory, inhibition of gastric acid secretion and pancreatic secretion, correcting water and electrolyte disturbance, and supportive therapy, i.e. more, acute pancreatitis caused by gallstones were treated by ERCP before. The control group were treated with Dachaihu Decoction Modified:Bupleurum 15g, Scutellaria 10g, Root of Herbaceous Ppeony Rhubarb 15g, Pinellia 10g,Citrus 20g,Aurantium 20g (after),Glauber's salt 10g (Chongfu), Salvia 20g, the method was:herbs are boiled two times, each time take the juice 150ml, mix the juice, then inject it through gastric tube 75ml four times per day. Treating group were given Chinese herb called Chai Xian Decoction Fufang: Bupleurum 15g, Scutellaria 10g, Root of Herbaceous Peony Rhubarb 15g, Pinellia 10 g,Citrus 20g,Aurantium 20g(after),Glauber's salt 10g (Chongfu) Salvia 20g,Euphorbia 0.5g(Chongfu, and stir well before treatment), the method was the same with controlling group. Patients were observed:①recovery time of serum amylase, white blood cell count and body temperature;②recovery time of normal bowel sounds, flatus, first anal defecation;③the value of reduced abdominal circumference;④recovery time of patients'abdominal distension, abdominal pain, nausea and vomiting, abdominal tenderness, the method of feeding juice:first pump gastric juice by one-time syringe, then feed for drugs. Make the temperature of juice 38-40 degrees. after feeding for juice,then feeding for the warm water 20ml, to prevent gastric juice left in the tube and immediately clamping the tube within 3 hours to prevent stomach juice outflow, which would affect the efficacy of drugs. Therapy for 5 days. If clear and thin stool turn runny bowel movements, daily volume≥800 ml, we could decrease the drug, or adehydration following diarrhea.Results:The lasting duration of serum amylase, temperature recovery time in treating group was shorter than the control group (P<0.05); The recovery time of normal bowel sounds in treating group was significantly shorter than the control group (P<0.01); The recovery time of flatus, first anal defecation in treating group was shorter than the control group (P<0.05); treating group was significantly reduced abdominal circumference greater than the control group (P<0.01); The recovery time of abdominal distension, abdominal pain, abdominal tenderness in treating group patients wsa shorter than the control group (P<0.05).Conclusions:Dachaihu Decoction Modified and Euphorbia are Chai Xian Decoction Fufang. The difference is the later have one herb more, but the later removes stagnant food and water in the intestines and relieves constipation and water by purgation. It has double effect. Chai Xian Decoction Fufang is more effective for the treatment of patients of acute pancreatitis with intestinal paralysis than Dachaihu Decoction Modified. It is worthy of further study and application. |
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