[1]彭志强,李凯,谢祥官,等.清解化攻方联合限制性液体复苏对重症急性胰腺炎患者胃肠功能及炎症因子的影响[J].陕西中医,2026,(1):59-65.[doi:DOI:10.3969/j.issn.1000-7369.2026.01.010]
　PENG Zhiqiang,LI Kai,XIE Xiangguan,et al.Effect of Qingjie Huagong prescription combined with restrictive fluid resuscitation on gastrointestinal function and inflammatory factors in patients with severe acute pancreatitis[J].,2026,(1):59-65.[doi:DOI:10.3969/j.issn.1000-7369.2026.01.010]
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清解化攻方联合限制性液体复苏对重症急性胰腺炎患者胃肠功能及炎症因子的影响

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年1期
页码:
59-65
栏目:
临床研究
出版日期:
2026-01-05

文章信息/Info

Title:
Effect of Qingjie Huagong prescription combined with restrictive fluid resuscitation on gastrointestinal function and inflammatory factors in patients with severe acute pancreatitis
作者:
彭志强; 李凯; 谢祥官; 蒋文婷; 冯晓云; 陈国忠
（广西中医药大学第一附属医院东葛院区，广西 南宁 530023)
Author(s):
PENG Zhiqiang; LI Kai; XIE Xiangguan; JIANG Wenting; FENG Xiaoyun; CHEN Guozhong
(Dongge Campus,The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023，China)
关键词:
重症急性胰腺炎; 清解化攻方; 液体复苏; 胃肠功能障碍; 炎症因子; 白蛋白
Keywords:
Severe acute pancreatitis; Qingjie Huagong prescription; Fluid resuscitation; Gastrointestinal dysfunction; Inflammatory factor; Albumin
分类号:
R 657.51
DOI:
DOI:10.3969/j.issn.1000-7369.2026.01.010
文献标志码:
A
摘要:
目的：本研究探讨清解化攻方联合限制性液体复苏对重症急性胰腺炎患者胃肠功能及炎症因子的影响。方法：选取50例重症急性胰腺炎患者为研究对象，将病例分为两组，治疗组25例在限制性液体复苏基础上联合清解化攻方治疗；对照组25例接受常规积极液体复苏治疗。观察指标包括72 h总输液量、72 h累计液体出量、血流动力学参数（心率及平均动脉压）以及治疗前后相关生化指标的变化情况。同时对两组研究患者的胃肠功能恢复情况及治疗过程中出现的严重并发症的发生率、病死率进行统计分析。结果：经过72 h的治疗，两组患者均实现了早期液体复苏的临床目标。组间对比结果显示，治疗组的细胞比容、心率、平均动脉压水平改善程度显著优于对照组（P＜0.05）。治疗组72 h内的总输液量及液体出量低于对照组（P＜0.05）。治疗7 d后，治疗组的白蛋白和前白蛋白水平较对照组升高（P＜0.05），而C反应蛋白和D-二聚体水平则降低（P＜0.05）。治疗第3、7天后，治疗组的白细胞计数水平、血淀粉酶及血肌酐改善幅度均优于对照组（P＜0.05）。治疗组的禁食、腹痛/腹胀缓解及肠鸣音恢复时间均短于对照组（P＜0.05）。治疗组的胃肠功能障碍评分、急性胰腺炎严重程度床边指数及中医证候评分均较对照组降低（P＜0.05）。治疗组并发症（腹腔间隔室综合征、急性呼吸窘迫综合征、急性肾衰竭、脓毒症及多器官功能障碍综合征）的发生及病死率均较对照组明显下降(均P＜0.05)。结论：在重症急性胰腺炎的治疗中，清解化攻方联合限制性液体复苏的治疗策略可显著抑制机体过度炎症反应，增强胃肠蠕动，促进胃肠功能恢复，并改善患者营养摄取水平，减少严重并发症风险，改善预后。
Abstract:
Objectives:This study was to investigate the effect of Qingjie Huagong prescription combined with restricted fluid resuscitation on gastrointestinal function and inflammatory factors in patients with severe acute pancreatitis.Methods:A retrospective cohort analysis was carried out in 50 patients with severe acute pancreatitis who were admitted to the hospital.Cases that met the inclusion criteria were divided into two groups according to different treatment regimens:the treatment group (25 cases) was treated with integrated traditional Chinese and Western medicine,that is,on the basis of restrictive fluid resuscitation combined Qingjie Huagong prescription;control group (25 cases) received routine active fluid resuscitation.The total transfusion volume in 72 hours,cumulative fluid output in 72 hours,hemodynamic parameters (heart rate and mean arterial pressure) and the changes of biochemical parameters before and after treatment were observed.At the same time,the recovery of gastrointestinal function and the incidence of serious complications,mortality and hospitalization expenses in the two groups were statistically analyzed.Results:After 72 hours of treatment,the clinical goal of early fluid resuscitation was achieved in both groups.Compared with the control group,the improvement of red cell volume,heart rate and mean arterial pressure in the treatment group was significantly better than that in the control group (P<0.05).The total infusion volume and fluid output in the treatment group were lower than those in the control group within 72 hours (P<0.05).After 7 days of treatment,the levels of albumin and prealbumin in the treatment group were higher than those in the control group (P<0.05),while the levels of C-reactive protein and D-dimer were lower (P<0.05).After 3 and 7 days of treatment,the improvement in white blood cell count,blood amylase and blood creatinine in the treatment group was significantly better than that in the control group (P<0.05).The time of fasting,abdominal pain/distension relief and bowel sound recovery in the treatment group were shorter than those in the control group (P<0.05),and the total cost of hospitalization was lower than that in the control group (P<0.05).The scores of gastrointestinal dysfunction,bedside index of acute pancreatitis severity and TCM syndrome in the treatment group were all lower than those in the control group (P<0.05).The incidence and mortality of complications (abdominal compartment syndrome,acute respiratory distress syndrome,acute renal failure,sepsis and multiple organ dysfunction syndrome) in the treatment group were significantly lower than those in the control group (all P<0.05).Conclusion:In the treatment of severe acute pancreatitis,the treatment strategy of Qingjie Huagong prescription combined with restrictive fluid resuscitation can significantly inhibit the body’s excessive inflammatory response,enhance gastrointestinal peristalsis,promote gastrointestinal function recovery,and improve patient nutritional uptake levels,reduce the risk of serious complications,and ultimately improve prognosis.

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备注/Memo

备注/Memo:
国家自然科学基金资助项目（82160890）；国家中医优势专科建设项目（2024010）；广西壮族自治区科学技术厅自然科学基金资助面上项目（2024GXNSFAA010246）；中央财政医疗服务与保障能力提升补助资金资助项目（2024001-02-05）；广西壮族自治区防城港市卫生健康委员会项目（防科 AB23006034）
更新日期/Last Update: 2026-01-08