韩乃巍

摘要目的：分析探討自拟清胰通腑汤治疗妊娠合并急性胰腺炎的疗效及对妊娠结局和新生儿的影响。方法：选取2014年6月至2015年6月青岛市即墨区中医医院收治的妊娠合并急性胰腺炎患者（APIP）42例，随机分为观察组（n=19）和对照组（n=23）。对照组采用常规方法治疗，观察组在对照组治疗基础上加用清胰通腑汤。观察2组治疗后的临床疗效、胃肠道功能改善时间、平均住院时间、白细胞计数（WBC）恢复正常时间、血清淀粉酶恢复正常时间、并发症发生率、妊娠结局、新生儿情况及炎性因子水平等。结果：观察组临床总有效率、妊娠结局及新生儿情况均优于对照组，并发症发生率低于对照组，细胞因子水平低于对照组（P<005）；观察组胃肠减压、WBC恢复正常时间、血淀粉酶恢复正常和住院时间均短于对照组（P<005）。结论：清胰通腑汤治疗APIP疗效明显，可改善肠道功能，缩短病程，降低炎性因子水平，减少并发症，改善妊娠结局和新生儿情况。

关键词清胰通腑汤；急性胰腺炎；疗效；妊娠结局；新生儿；影响

Clinical Observation on Selfmade Qingyi Tongfu Decoction in the Treatment of Acute Pancreatitis in Pregnancy

Han Naiwei

（Department of Pharmacy，Jimo District Hospital of Traditional Chinese Medicine，Qingdao 266200，China）

AbstractObjective：To investigate the effects of Qingyi Tongfu Decoction on acute pancreatitis in pregnancy and its effects on pregnancy outcome and newborn.Methods：From June 2014 to June 2015，42 women with acute pancreatitis in pregnancy （APIP） in Jimo District Hospital of Traditional Chinese Medicine were randomly divided into 2 groups，with 19 cases in the observation group and 23 cases in the control group.The control group received conventional treatment，while the observation group was given Qingyi Tongfu Decoction on the basis of the control group.The clinical efficacy of the 2 groups，the improvement time of gastrointestinal function，the average time of hospitalization，the recovery of white blood cell count （WBC），the normal time of serum amylase recovery，the incidence of complications，the outcome of pregnancy，the situation of newborn and the level of inflammatory factors were observed.Results：The clinical total effective rate，pregnancy outcome and newborns in the observation group were better than the control group.The incidence of complications was less than that of the control group.The level of cytokines was lower than that of the control group （P<005）.The gastrointestinal decompression，the normal recovery time of WBC，the normal recovery of blood amylase and the time of hospitalization in the treatment group were shorter than those in the control group （P<005）.Conclusion：The effects of Qingyi Tongfu Decoction in the treatment of APIP patients were obvious.It can improve the intestinal function，shorten the course of disease，reduce the level of inflammatory factors，reduce the incidence of complications，improve the pregnancy outcome and the situation of the newborn.

Key WordsQingyi Tongfu Decoction； Acute pancreatitis； Curative effect； Pregnancy outcome； Newborn′s influence

中图分类号：R242；R2856文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.08.028

近年来，妊娠合并急性胰腺炎（Acute Pancreatitis in Pregnancy，APIP）的发病率呈上升趋势，受到广泛关注[1]。APIP可发生在妊娠早、中或晚期，其中以妊娠晚期最为常见，其发病多突然，病情进展迅速，若早期不采取有效治疗或干预措施，易出现多器官功能损害，而且并发症多，严重危害母婴生命[23]。西医临床上多给予禁食、胃肠减压、补液、肠外营养及纠正水、电解质紊乱。急性胰腺炎属中医学“腹痛”范畴，多由暴饮暴食、情志不遂等因素所致，导致机体气滞血瘀[45]。基于此，我院对19例APIP患者采用自拟清胰通腑汤联合西医治疗，现将结果报道如下。

1资料与方法

11一般资料选取2014年6月至2015年6月我院收治的APIP患者42例，按治疗方法不同分为2组，观察组19例，年龄21～38岁，平均年龄（3069±392）岁；……