研究疾病:
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重症急性胰腺炎
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研究疾病代码:
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Target disease:
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severe acute pancreatitis
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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I期临床试验
Phase I clinical trial
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研究目的:
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中医药作为现代内科综合治疗重症急性胰腺炎(severe acute pancreatitis, SAP)的重要组成部分,在提高SAP临床疗效、改善患者预后方面发挥了积极作用。其中,以大承气汤为代表的通里攻下法协同西医药治疗SAP的确切疗效已形成共识,但少有研究提及中医药治疗介入时机对SAP患者临床疗效及预后的影响。故本研究拟以预测的SAP患者为研究对象,采用随机、平行对照的方法,观察在常规西医治疗基础上,不同时机(入院第1天内、入院第2天内、入院第3天及以后)运用大承气汤治疗SAP的有效性、安全性及疗效的差异性,分析探讨SAP的最佳中药介入治疗时机,以给临床工作者提供参考依据,为促进中医药在SAP临床的推广运用提供循证医学证据。
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Objectives of Study:
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At present, there is no effective treatment. As an important part of modern internal medicine comprehensive treatment of severe acute pancreatitis (SAP), traditional Chinese medicine has played a positive role in improving the clinical efficacy and prognosis of SAP. Among them, there is a consensus on the exact efficacy of Tongfu method represented by Dachengqi decoction combined with western medicine in the treatment of sap, but few studies mention the impact of intervention time of traditional Chinese medicine on the clinical efficacy and prognosis of SAP patients. Many guidelines recommend that SAP should be treated with purgative and purgative therapy as soon as possible, but the application proportion of traditional Chinese medicine in SAP is still not high because the timing and mode of intervention are still controversial. Therefore, this study intends to take the predicted patients with SAP as the research object, adopt the method of random and parallel control, observe the differences in the effectiveness, safety and efficacy of Dachengqi Decoction in the treatment of SAP at different times (within the first day of admission, within the second day of admission, on the third day of admission and after) on the basis of routine western medicine treatment, analyze and explore the best time of traditional Chinese medicine intervention treatment for SAP, so as to provide reference for clinical workers, To provide evidence-based medical evidence for promoting the popularization and application of traditional Chinese medicine in SAP clinic.
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药物成份或治疗方案详述:
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Description for medicine or protocol of treatment in detail:
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纳入标准:
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(1)符合AP的诊断标准;
(2)符合腑实热结证的诊断标准;
(3)符合预测的SAP的诊断标准:根据文献报道,本研究将预测的SAP定义为入院时符合以下任意条件之一的AP患者:① APACHE II评分≥8分;② BISAP评分≥3分;③ PASS评分>140分;④ CRP>150mg/mL;
(4)发病(腹痛开始)后48小时内入院;
(5)性别不限,年龄18~85岁;
(6)同意参加本研究,并获得患者或其法定代表人的书面知情同意。
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Inclusion criteria
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(1) Meet the diagnostic criteria of AP;
(2) Meet the diagnostic criteria of Fu excess heat syndrome;
(3) Meet the diagnostic criteria of predicted SAP: ① APACHE II score ≥ 8, and/ or ② BISAP score ≥ 3, and/ or ③ Pass score > 140, and/ or ④ CRP>150mg/mL.
(4) Admission within 48 hours after onset (onset of abdominal pain);
(5) Regardless of gender, 18-85 years old;
(6) Agree to participate in this study and obtain the written informed consent of the patient or his legal representative.
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排除标准:
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(1)慢性胰腺炎、胰腺肿瘤,或患有其他器官系统的慢性严重性疾病,以及恶性肿瘤患者;
(2)合并胃肠穿孔、消化道出血、完全性肠梗阻患者;
(3)病情严重需行外科手术、腹腔灌洗等非内科治疗患者;
(4)发病前有外伤、手术史的患者;
(5) 起病前 3 个月加入其他临床试验的患者;
(6) 妊娠合并急性胰腺炎或哺乳期患者;
(7) 入院前已使用中药治疗。
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Exclusion criteria:
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(1) Patients with chronic pancreatitis, pancreatic tumors, or chronic serious diseases of other organ systems, as well as malignant tumors;
(2) Patients with gastrointestinal perforation, gastrointestinal bleeding and complete intestinal obstruction;
(3) Patients with serious condition who need non medical treatment such as surgery and peritoneal lavage;
(4) Patients with a history of trauma and surgery before onset;
(5) Patients who joined other clinical trials 3 months before onset;
(6) Pregnancy complicated with acute pancreatitis or lactation;
(7) Patients who were treated with traditional Chinese medicine before admission.
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研究实施时间:
Study execute time:
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从From
2022-01-01
至To
2023-12-31
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征募观察对象时间:
Recruiting time:
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从From
2022-04-26
至To
2023-12-31
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