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目的 观察生大黄和 5 -氟尿嘧啶 (5 - Fu)对急性胰腺炎的治疗效果 ,并探讨其作用机制。方法 34例患者 (含重症 5例 )采用生大黄和 5 - Fu治疗 ,于入院时及入院后 2 4,36 ,48,72 h观察临床症状、白细胞 (WBC)、血淀粉酶 (AMS)、谷丙转氨酶 (AL T)、胆红素 (BIL IT)、乳酸脱氢酶 (L DH )、血糖(Glu)和动脉血氧分压 (Pa O2 )的变化。结果 34例治疗患者显效 2 5例 ,好转 5例 ,无效 4例 ,显效率74%,总有效率 88%;其中轻症及中症胰腺炎患者 ,显效率和总有效率各为 86 %和 10 0 %。结论 生大黄和 5 - Fu可以明显缓解患者症状 ,改善微循环 ,促进肠蠕动恢复 ,抑制细菌移位 ,抑制白细胞释放炎性介质 ,阻断 SIRS与胰腺自身消化的恶性循环 ,促进胰腺组织恢复 ,总的治疗效果良好。
Objective To observe the therapeutic effect of rhubarb and 5 - fluorouracil (5 - Fu) on acute pancreatitis and to explore its mechanism. Methods 34 patients (including 5 severe cases) were treated with rhubarb and 5 - Fu. The clinical symptoms, white blood cell (WBC), blood amylase (AMS) Alterations of ALT, BIL IT, L DH, Glu and Pa O2 were measured. Results In 34 cases, the effective rate was 25%, improvement in 5 cases, ineffective in 4 cases, markedly effective rate in 74%, and total effective rate in 88%. In mild and moderate pancreatitis, the effective rate and total effective rate were 86% and 10 0%. Conclusion Rhubarb and 5 - Fu can relieve symptoms, improve microcirculation, promote the recovery of intestinal peristalsis, inhibit bacterial translocation, inhibit the release of inflammatory mediators from leukocytes, block the vicious cycle of SIRS and pancreatic digestion and promote the recovery of pancreatic tissues. The overall treatment is good.