柴芍六君子汤合膈下逐瘀汤联合常规疗法治疗慢性胰腺炎术后临床研究
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Clinical Study on Chaishao Liujunzi Tang and Gexia Zhuyu Tang Combined with Routine Therapy for Patients after Surgery of Chronic Pancreatitis
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    摘要:

    目的:观察柴芍六君子汤合膈下逐瘀汤加减方联合现代医学常规疗法治疗慢性胰腺炎(CP) 的临床疗效。方法:将90例CP术后患者随机分为对照组和观察组各45例。2组均行内镜治疗,术后服用胰酶肠溶胶囊、奥美拉唑肠溶胶囊,若疼痛不能控制则服用氨酚曲马多片。观察组加予柴芍六君子汤合膈下逐瘀汤加减方内服。2组疗程均为8周。评价2组患者的术后疼痛情况[视觉模拟评分法(VAS)]及统计氨酚曲马多片使用情况,治疗前后评定中医证候积分和胃肠生活质量量表(GIQLI) 评分,治疗后评价脂肪吸收指数(CFA),比较2组的中医证候疗效。结果:治疗后,观察组中医证候疗效优于对照组(P<0.05)。2 组治疗3 d、5 d、7 d 的VAS 评分均呈逐渐下降趋势(P<0.01)。观察组治疗3 d、5 d、7 d 的VAS 评分均低于对照组(P<0.01)。2组中医证候积分均较治疗前下降(P<0.01),GIQLI评分均较治疗前升高(P<0.01)。观察组中医证候积分低于对照组(P<0.01),GIQLI评分高于对照组(P<0.01)。观察组氨酚曲马多片使用量少于对照组,CFA高于对照组,差异均有统计学意义(P<0.01)。结论:在术后常规疗法基础上加用柴芍六君子汤合膈下逐瘀汤加减方治疗CP患者,近期可有效减轻腹痛,减少氨酚曲马多片的使用量,远期可有效缓解临床症状,改善脂肪吸收情况和胰腺分泌功能,提高患者的生活质量,有着较好的临床疗效。

    Abstract:

    Abstract:Objective:To observe the clinical effect of modified Chaishao Liujunzi tang and Gexia Zhuyu tang combined with routine therapy of modern medicine for chronic pancreatitis(CP). Methods: A total of 90 cases of CP patients after surgery were randomly divided into the control group and the observation group,45 cases in each group. After endoscopic therapy,both groups were treated with pancreatin enteric- coated capsules and omeprazole enteric- coated capsules,and paracetamol and tramadol hydrochloride tablets if the pain can not be controlled. The observation group was additionally treated with oral administration of modified Chaishao Liujiunzi tang and Gexia Zhuyu tang. Both groups were treated for eight weeks. The postoperative pain[Visual Anglogue Scale(VAS)] and the use of paracetamol and tramadol hydrochloride tablets in the two groups were evaluated; the Chinese medicine syndrome scores and the scores of Gastrointestinal Quality of Life Index(GIQLI) before and after treatment,as well as the Coefficient of Fat Absorption(CFA) after treatment were evaluated; the curative effect on Chinese medicine syndromes was compared between the two groups. Results:After treatment,the curative effect of Chinese medicine syndromes in the observation group was better than that in the control group(P<0.05). The VAS scores on the 3rd,5th and 7th day of treatment showed a gradual downward trend in the two groups(P<0.01),and the above scores in the observation group were all lower than those in the control group(P<0.01). The Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P<0.01),and the GIQLI scores were increased(P<0.01). The Chinese medicine syndrome scores in the observation group were lower than those in the control group(P<0.01),and the GIQLI score was higher(P<0.01). The usage of paracetamol and tramadol hydrochloride tablets in the observation group was less than that in the control group, and the CFA was higher than that in the control group,differences being significant(P<0.01). Conclusion:Based on routine postoperative therapy,the therapy of modified Chaishao Liujunzi tang and Gexiao Zhuyu tang has good clinical effect in treating CP patients,which can effectively relieve abdominal pain and reduce the usage of paracetamol and tramadol hydrochloride tablets in a short term, and effectively improve clinical symptoms,fat absorption,pancreatic secretion function and quality of life in a long term.

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段文飞.柴芍六君子汤合膈下逐瘀汤联合常规疗法治疗慢性胰腺炎术后临床研究[J].新中医,2020,52(12):25-28

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  • 在线发布日期: 2020-06-15
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