急性重症胰腺炎患者使用中药热敷缓解腹部症状护理实践

高漫,夏秀丹,罗曼,罗芬,姜晓锋,向红英,岳彬,邵旋

【摘要】目的 分析中药热敷缓解腹部症状护理应用于急性重症胰腺炎患者临床中的效果。方法本次研究选取的对象共80例，均为我院收治的急性重症胰腺炎患者，随机将其分为对照组（采用常规护理）、观察组（采用中药热敷缓解腹部症状护理），比较两组护理效果。结果 与对照组相比，观察组患者治疗总有效率更高，差异显著（P＜0.05）；两组患者症状缓解时间的比较，观察组短于对照组，差异显著（P＜0.05）。结论 中药热敷缓解腹部症状护理能改善急性重症胰腺炎的临床症状，其值得推广使用。

【关键词】急性重症胰腺炎；中药热敷；腹部症状

急性重症胰腺炎具有并发症多、病死率高等特点，多数患者病死于疾病早期阶段，近年来，随着SAP外科治疗的发展，该疾病的治愈率得到提升[1]。对于重症胰腺炎患者来说，引发改该疾病的引发因素包括胆道疾病、酗酒、暴饮暴食等，由此导致胰蛋白酶大量活化，胰腺组织消化，造成胰腺水肿、局部组织坏死的问题，其会导致患者出现各器官及系统功能的异常。为了提高患者临床疗效，在对患者采取有效治疗方法的同时，还需要为其采取有效护理干预，本次研究主要就中药热敷缓解腹部症状护理的应用效果进行分析，具体如下。

1.资料与方法

1.1一般资料

本次研究纳入急性重症胰腺炎患者共80例，随机将其分为对照组（n=40）、观察组（n=40）；对照组男女人数比为22:18，年龄最小35岁，最大56岁，平均年龄（43.23±2.31）岁；观察组男女人数比为23:17，年龄最小、最大分别为36岁、57岁，平均年龄（44.32±3.02）岁；两组患者一般资料的比较差异显著（P＞0.05），可比性较高。

纳入标准：（1）确诊为急性重症胰腺炎的患者；（2）治疗依从性较高的患者；（3）自主签署知情同意书的患者。

纳入标准：（1）患有合并其他严重疾病的患者；（2）精神疾病的患者的患者.

1.2方法

对照组：采用常规治疗法，包括禁食、持续胃肠减压、体液复苏等治疗；观察组：在对照组基础上采用中药热敷缓解腹部症状护理，取15g大黄、姜黄、黄柏、白芷，10g天南星、陈皮、厚朴、苍术、甘草，20g天花粉，将以上药材共研细末混匀，采用食醋将其调成糊状，在患者腹部压痛部位进行敷贴。敷贴的范围应超出腹部压痛范围的3~5cm，厚度为0.8cm，每天换药1次，一个疗程为3~5天[2]。

1.3观察指标

对两组患者的临床疗效进行比较，治疗总有效率=显效率+有效率；对两组患者的症状缓解时间进行比较。

1.4统计学方法

本次研究采用 SPSS19.0 软件对相关数据进行统计和分析，计量资料、计数资料分别用（±s）、（%）表示，用t、x2进行检验，P＜0.05，表明两组间的差异具有统计学意义。

2.结果

2.1两组患者临床疗效的比较

观察组患者临床治疗总有效率更高，差异显著（P＜0.05），见表1。

表1 两组患者临床疗效的比较

组别	n	显效	有效	无效	总有效率
对照组	40	11（27.50）	19（47.50）	10（25.00）	30（75.00）
观察组	40	23（57.50）	15（37.50）	2（5.00）	38（95.00）
x2	-	-	-	-	6.274
P	-	-	-	-	＜0.05

2.2两组患者症状缓解时间的比较

观察组患者症状缓解时间更短，差异显著（P＜0.05），见表2。

表2 两组患者症状缓解时间的比较

组别	n	腹胀消失时间	腹痛消失时间	胃肠功能恢复时间
对照组	40	5.51±0.82	5.32±1.13	4.03±0.82
观察组	40	3.43±0.62	3.54±0.62	2.33±0.34
t	-	12.796	8.734	12.111
P	-	＜0.05	＜0.05	＜0.05

3.讨论

重症急性胰腺炎的引发因素包括胆道疾病、酗酒、暴饮暴食，其约占全部急性胰腺炎的10%~20%左右，患有该疾病的患者病情十分危重，其对患者的生命健康安全带来极大的影响3]。临床对该疾病通常采用西医治疗法，其虽然能改善患者临床症状，但是整体疗效还有所欠佳。

当前临床对重症急性胰腺炎患者逐渐采用中医治疗法，从中医角度上来看，胰腺炎属于“脾心痛”、“结胸”的范畴，饮食不规律、长期劳累、酗酒等将直接影响患者的机体，而在风寒湿邪侵袭的影响下，脾胃肝胆功能会出现紊乱的现象。中医在治疗该疾病时以通腑泄热、

疏肝理气为主，通过对患者采取中药热敷缓解腹部症状护理能取得显著效果，中药材包括大黄、姜黄、黄柏、白芷、天南星、陈皮、厚朴、苍术、甘草、天花粉等，其中的大黄能发挥其通腑泄热的作用，姜黄能发挥其通经止痛的功效，黄柏具有清热燥湿、泻火解毒的治疗效果；白芷在散寒止痛方面发挥显著功效，天南星的解毒消肿，陈皮的理气健脾，厚朴的燥湿消痰、下气除满，苍术的健脾、燥湿，甘草的镇痛，以及天花粉的解毒消痈，能有效改善患者临床症状，尤其是腹部症状的缓解方面具有显著优势

[4]。

本次研究结果显示：与对照组相比，观察组患者临床治疗总有效率更高，症状缓解时间更短，差异显著（P＜0.05）。由此说明，对急性重症胰腺炎患者使用中药热敷缓解腹部症状护理干预能取得十分理想的效果，其具有重要临床应用价值。

综上所述，中药热敷缓解腹部症状护理具有的优势，值得在急性重症胰腺炎患者临床中推广使用。                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      

【参考文献】

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[2]张家墉,王少辉,白垚. 中药联合腹腔镜下置管灌洗引流术治疗急性重症胰腺炎疗效观察[C]//中国中西医结合学会消化系统疾病专业委员会.第三十一届全国中西医结合消化系统疾病学术会议论文集.[出版者不详],2019:343.

[3]郭世勋.中药辅助治疗急性重症胰腺炎的临床效果[J].深圳中西医结合杂志,2018,28(19):64-65.

[4]付瑜.中药灌肠联合西药治疗急性重症胰腺炎临床研究[J].中医学报,2017,32(11):2095-2098.