摘要:目的: 評價生長抑素(somatostatin,商品名Stilamin,思他寧) 和甲磺酸加貝酯(gabexate mesilate,GM)治療急性胰腺炎患者的療效,及這兩種藥物對急性出血壞死型胰腺炎的臨床療效。 方法 :采用隨機對照研究,按是否出血壞死型隨機分為治療組和對照組,在常規治療的基礎上,分別接受思他寧或甲磺酸加貝酯治療,并觀察療效。 結果 : 思他寧用于治療急性水腫型胰腺炎,總有效率達100 0 %,痊愈率達789 %,略高于對照組加貝酯(636 %),但差異無顯著性(〖WTBX〗 P gt;0 05)。腹痛、上腹脹等癥狀均能在3～5 d 內基本緩解或消失。思他寧用于治療急性出血壞死型胰腺炎,總有效率90 %,高于對照組加貝酯667％,差異有顯著性( 〖WTBX〗P ＜005)。治療過程中僅2 例丙氨酸轉氨酶輕度升高,未發現過敏、皮疹、白細胞明顯下降等明顯不良反應,肝、腎功能和電解質等生化指標和血常規監測顯示其具有較好的安全性。 結論 :思他寧和加貝酯用于治療急性水腫型胰腺炎和出血壞死型胰腺炎均有較好的療效,不良反應較少。在急性水腫型胰腺炎治療中,二者總有效率無顯著性差異;在出血壞死型胰腺炎治療中,思他寧總有效率高于加貝酯。Abstract: Objective: To assess the effectiveness of somatostatin (Stilamin) and gabexate mesilate(GM) in the treatment of patients with acute edematic pancreatitis (AEP) and acute hemorragic and necrotic pancreatitis (AHNP). Methods :Patients were randomly alloccated into the treatment group (with Stilamin) and control group (with gabexate ) which were stratified by AHNP or AEP. All the side effects were recorded during the whole process. Results :Totally 57 acute pancreatitis patients were enrolled (male 31,female 26). Among them,41 cases were mild,16 cases were severe. The study showed that total ef2 fectiveness of Stilamin in treating acute pancreatitis was 100 %,while the cured rate was 789 %,a little bit higher than control group with cabexate (636 %),but no statistical significance existed. Total effectiveness of Stilamin in treating AHNP was similar as that of sandostatin (900 % vs 667 %, 〖WTBX〗P = 0 031). The main complication after treating AHNP was pancreatic pseudocyst. Only two case showed increase of ALT. No side effects of hypersensitivity,skin rash,WBC decrease were noted. Safety had been proved by monitoring of liver and renal function,eletrolytes and blood RT. Conclusion :Stilamin and gabexate showed effectiveness in treating AEP and AHNP with fewer side effects. The total effectiveness of Stilamin in treating AHNP was higher than control group with gabexate, and statistical significance existed.
Traditional Chinese Medicine (TCM) clinical practice guidelines play essential roles in the development of TCM. However, the existing TCM guidelines are not effectively used in clinic. Based on this phenomenon, this article addresses the characteristics of clinical practice guidelines of TCM, and analyzes its status, problems and resolutions, providing feasible suggestions for the development of high-quality clinical practice guidelines of TCM which are in accordance with clinical practice.
It is very important to develop and revise expert panel consensus on Chinese patent medical clinical application. The contents of the expert panel consensus include determination of the subject, clarity of the application scope, indications, dosage and administration, and safety of Chinese patent medicine. In the process, clinical researchers establish project team, formulate clinical management questions, select the outcome index, retrieve and make the evidence, and develop expert consensus with consensus methods strictly according to the requirements of methodology.