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目的通过复方丹参静脉滴注和清胰汤保留灌汤与善宁在治疗重症急性胰腺炎(SAP)疗效及卫生经济学价值的比较,探讨非手术治疗SAP的有效且价廉的方法。方法62名患者随机分为治疗组(复方丹参和清胰汤保留灌肠组)与对照组(善宁组)。对患者的临床症状改善时间,血清淀粉酶和血常规复常时间,住院天数和住院费用,最终死亡率进行比较,并比较治疗组入院后12h内实施清胰汤保留灌肠与12h后实施在临床疗效上的差异。结果治疗组在腹部压痛体征消除时间,首次排大便时间,恢复进食时间比对照组明显缩短,住院费用明显减少,差异显著(P<0.05),腹痛初步缓解时间、血清淀粉酶、血常规复常时间、住院天数无明显差异。入院后12h内实施清胰灌汤保留灌肠,其腹部压痛体征消除时间,恢复进食时间比12h后实施更有明显缩短(P<0.05)。两组最终病死率无显著差别。结论复方丹参和清胰汤保留灌肠,尤其早期实施保留灌肠,可明显改善SAP病情,卫生经济学比善宁更具有优势。对病死率的影响因样本少需进一步研究。
Objective To compare the curative effect and health economics value of Compound Salviae Miltiorrhizae intravenous dripping and Qingyi Decoction preserving Gansu Tang and Shanning on the treatment of Severe Acute Pancreatitis (SAP) and to explore the effective and inexpensive method of non-surgical treatment of SAP. Methods Sixty-two patients were randomly divided into treatment group (compound salvia miltiorrhiza and Qingyi decoction retention enema group) and control group (Shannon group). The clinical symptoms of patients improved time, serum amylase and blood routine recovery time, hospitalization days and hospitalization costs, the final mortality were compared and the treatment group within 12h after admission Qingyutang retention enema and 12h after the implementation of the clinical Differences in efficacy. Results In the treatment group, the signs of abdomen tenderness elimination, the time of the first row of bowel movements and the time of recuperation were significantly shorter than those of the control group, and the cost of hospitalization significantly decreased (P <0.05). The initial relief time of abdominal pain, serum amylase, Time, hospital days no significant difference. Qingyuan irrigation decoction retention enema within 12h after admission, abdomen tenderness elimination time, recovery time was significantly more than 12h (P <0.05). There was no significant difference in final mortality between the two groups. Conclusion The compound Salvia miltiorrhiza and Qingyi decoction retain the enema, especially the early implementation of retention enema, can significantly improve the disease of SAP, health economics more advantages than the Ning. The impact on mortality due to the sample needs little further study.