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目的:探讨L-谷氨酰胺呱仑酸钠联合柴芍承气汤胃管注入治疗急性重症胰腺炎并发肠麻痹患者的疗效。方法:52例急性重症胰腺炎并发肠麻痹患者随机分成两组,对照组26例,给予常规治疗及胃管内注入柴芍承气汤,治疗组26例,给予常规治疗及L-谷氨酰胺呱仑酸钠联合柴芍承气汤胃管注入。分别观察首次排便时间,腹胀腹痛持续时间,肠道功能恢复时间以及并发症发生率,并检测各组患者血清二胺氧化酶(DAO)的变化。结果:治疗组患者腹痛腹胀持续时间、首次排便时间分别为(5·89±1·76)d和(8·51±2·36)h,低于对照组的(7·68±1·33)d和(10·23±2·51)h(P<0·05);治疗组并发症发生率为7·69%,低于对照组的23·07%(P<0·05)。两组治疗前DAO分别为(15·58±3·33)和(15·33±3·52),差异无统计学意义,治疗后第7天治疗组DAO为(8·8±3·4)U/L,低于对照组的(9·9±3·1)U/L(P<0·05)结论:L-谷氨酰胺呱仑酸钠联合柴芍承气汤治疗能促进肠道屏障功能的修复,有效缩短急性胰腺炎患者肠道功能恢复时间,减少并发症发生率,对急性胰腺炎并发肠麻痹疗效显著。
Objective: To investigate the curative effect of L-glutamine combined with Chaisheng Chengqi soup in the treatment of acute severe pancreatitis complicated with intestinal paralysis. Methods: Fifty-two patients with acute severe pancreatitis complicated with intestinal paralysis were randomly divided into two groups, control group, 26 cases, given conventional treatment and intragastric administration of Chai Shao Cheng Qi Tang, the treatment group of 26 patients, given conventional treatment and L-glutamine Gouron sodium combined Chaisheng Chengqi soup tube injection. The time of first defecation, the duration of abdominal distension and abdominal pain, the recovery time of intestinal function and the incidence of complications were observed. The changes of serum diamine oxidase (DAO) in each group were also measured. Results: The duration of abdominal distension and initial defecation time in the treatment group were (5.89 ± 1.76) d and (8.51 ± 2.36) h, respectively, which were lower than those in the control group (7 · 68 ± 1.33 ) and (10.23 ± 2.51) h (P <0.05). The incidence of complications in the treatment group was 7.69%, which was lower than 23.07% in the control group (P <0.05). The DAO of the two groups before treatment was (15.58 ± 3.33) and (15.33 ± 3.52), respectively, with no significant difference. On the seventh day after treatment, the DAO in the treatment group was (8 · 8 ± 3 · 4) ) U / L, which was lower than that of the control group (9.9 ± 3.1) U / L (P <0.05) Conclusion: L-glutamine combined with Chaishao Chengqi Decoction can promote intestinal Road barrier function of the repair, effectively shorten the recovery time of intestinal function in patients with acute pancreatitis and reduce the incidence of complications, the efficacy of acute pancreatitis complicated by intestinal paralysis.