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目的观察清胰汤联合乌司他丁治疗重症急性胰腺炎合并肺损伤的疗效。方法选取2014年5月—2015年4月收治的重症急性胰腺炎合并肺损伤患者90例,采用数字表法随机分为观察组和对照组,每组45例。对照组在常规治疗的基础上给予乌司他丁治疗,观察组在对照组基础上采用清胰汤胃管鼻饲治疗。观察2组的治疗效果、肠胃功能恢复以及治疗前后炎性因子水平,并对2组行血气分析。结果观察组的治疗总有效率为91.11%,对照组为73.33%,2组差异具有统计学意义(P<0.05);观察组患者腹痛、腹胀、排气、排便等恢复时间和血淀粉酶、白细胞恢复至正常时间均短于对照组(P<0.05);治疗后,2组患者血清中的炎性因子白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)及高敏C反应蛋白(Hs-CRP)的表达与治疗前相比均显著降低(P<0.05),观察组的上述指标均显著低于对照组(P<0.05);治疗后2组的血气分析指标Pa O2、Pa CO2、Pa O2/Fi O2与治疗前相比均显著升高(P<0.05),观察组的上述指标均显著高于对照组(P<0.05)。结论清胰汤联合乌司他丁治疗重症急性胰腺炎合并肺损伤能够有效改善患者的胃肠功能,抑制炎性反应,促进患者肺功能恢复,值得临床推广应用。
Objective To observe the curative effect of QingYi decoction combined with ulinastatin on severe acute pancreatitis complicated with lung injury. Methods Ninety patients with severe acute pancreatitis and lung injury who were admitted from May 2014 to April 2015 were randomly divided into observation group and control group with 45 cases in each group. The control group was treated with ulinastatin on the basis of routine treatment. The observation group was treated with qingyitang stomach tube nasal feeding on the basis of the control group. The therapeutic effects, the recovery of gastrointestinal function and the levels of inflammatory cytokines in the two groups were observed before and after treatment. Blood gas analysis was performed on the two groups. Results The total effective rate was 91.11% in the observation group and 73.33% in the control group, with significant difference between the two groups (P <0.05). The recovering time of abdominal pain, abdominal distension, excretion and defecation in the observation group was significantly lower than that of the blood amylase, After the treatment, the levels of IL-6, IL-10, TNF-α and IL-10 in the serum of the two groups were significantly lower than those of the control group (P <0.05) The expression of TNF-α and Hs-CRP in the observation group were significantly lower than those in the control group (P <0.05) PaO2, PaCO 2 and Pa O 2 / Fi O 2 in the latter two groups were significantly higher than those before treatment (P <0.05). The above indexes in the observation group were significantly higher than those in the control group (P <0.05). Conclusion Qingyitang combined with ulinastatin in severe acute pancreatitis with lung injury can effectively improve gastrointestinal function, inhibit inflammatory reaction and promote pulmonary function recovery, which is worthy of clinical application.