| Objective: To observe the curative effect of Qingjie Huagong Decoction in the treatment of moderate and severe acute pancreatitis(SAP),and to explore the therapeutic effect and mechanism of Qingjie Huagong Decoction in the treatment of SAP with the principles of clearing away heat,removing dampness and detoxification,activating blood circulation and removing blood stasis,so as to provide new ideas and theoretical basis for the synergistic effect of traditional Chinese medicine in the treatment of SAP.Methods: Collected into standard of 60 patients with SAP,were randomly divided into control group and observation group,each 30 cases and control group in the internal medicine comprehensive treatment: fasting,gastrointestinal decompression,early fluid resuscitation,acid suppression inhibition of pancreatic enzyme secretion,early enteral nutrition,specification of antibiotic use,improving pancreas microcirculation,maintenance support therapy such as viscera function;On the basis of comprehensive treatment in internal medicine,the observation group was set with Qingjie Huagong Decoction attack prescription(internal administration and enema).After treatment compared two groups of comprehensive curative effect evaluation,in patients with clinical symptoms(abdominal pain,abdominal distention,nausea,vomiting,etc.),gastrointestinal function(bowel sounds,anal exhaust defecation,enteral nutrition,etc.),biochemical indicators(S-Amy,CRP,D-dimer,PAF,arterial blood lactic acid,etc.)and grading(APACHE II score,BISAP score and MCTST score),observe the hospitalization days,etc.Results:(1)In terms of comprehensive curative effect,according to the evaluation criteria of curative effect of the disease,on the 7th day after treatment,among the 29 cases in the observation group,19 cases were under clinical control,6 cases were significantly effective,3 cases were effective,1 case was ineffective,and the total effective rate was 96.56%;Among the 28 cases in the control group,11,9 cases were significantly effective,5 cases were effective,3 cases were ineffective,and the total effective rate was 89.29%.The total effective rate in the observation group was better than that in the control group by the rank sum test,P<0.05.(2)In terms of the improvement of the clinical manifestations of the patients,except for nausea and vomiting,the scores of abdominal pain,abdominal distension and bowel sounds in the patients were compared,and the scores in the observation group were less than those in the control group(P<0.05).Comparison of the time required for the recovery of gastrointestinal function in patients with intestinal rumbling,anal exhaust and open enteral nutrition,the observation group was earlier than the control group(P<0.05).Quantitative integral comparison of symptoms and syndromes between the two groups,the observation group was less than the control group(P<0.05)(3)Serum amylase,CRP,PAF,d-dimer,and arterial blood lactic acid of the patients were improved in similar levels after treatment in the two groups(P>0.05).The levels of CRP,PAF,d-dimer and arterial blood lactic acid in the observation group were significantly lower than those in the control group on day 3 and day 7(P<0.05).To sum up,the observation group was superior to the control group in terms of the improvement of patients' clinical performance.(4)APACHE II score: compared between the two groups,APACHE II score in the observation group was significantly lower on the third day and the seventh day of treatment(P<0.05).BISAP score: there was no significant difference in the comparison of BISAP score between the two groups on the 3rd day and the 7th day,P>0.05,indicating that there was no significant difference in the improvement of BISAP score between the two groups after treatment.MCTSI score: compared with the same period of treatment,there was no significant difference between the two groups on day 3(P>0.05),suggesting that the efficacy of the two groups was similar on day 3,P<0.05 was compared between the two groups on day 7,indicating that the MCTSI score in the observation group was significantly improved compared with that in the control group on day 7,and the effect was obvious.(5)In terms of length of stay,the length of stay in the observation group was significantly shorter than that in the control group,which reduced the length of stay of the patients(P<0.05).conclusion(1)In the treatment of Western medicine,Qingjie Huagong Decoction can more effectively alleviate the clinical symptoms and signs of SAP patients,alleviate intestinal paralysis,help the recovery of gastrointestinal and pancreatic functions,reduce the levels of CRP,D-dimer,PAF,arterial blood lactic acid,maintain the stability of organ function,reduce body score,and has obvious advantages over the treatment of SAP with Western Medicine alone.(2)The mechanism of action of Qingjie Huagong Decoction on SAP is related to improving local microcirculation of pancreas,inhibiting inflammation,promoting gastrointestinal peristalsis,repairing intestinal barrier and preventing bacterial translocation.(3)There are no obvious adverse reactions in the treatment of SAP by Qingjie Huagong Decoction offensive prescription,which is safe and feasible.It provides a new treatment idea and plays an important synergistic role in the treatment of SAP by traditional Chinese medicine. |
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