RESUMO
Objective To investigate the optimal initial timing of Qingyi Decoction and clyster with rhubarb in patients with severe acute pancreatitis (SAP). Methods Patients with SAP were randomly divided into 2 groups. The group A (n = 34) received clyster with rhubarb and Qingyi Decoction after 12 h of SAP onset and the group B (n = 27) received samel therapy after 72 h of onset of SAP. The serum levels of TNF-α, CRP and APACHE Ⅱ scores, time to abdominal pain cessation, length of hospital stay and medical costs were compared. Results The serum levels of TNF-α and CRP of patients in group A were (265±66)U/ml, (32.1 ±7.1) mg/L, and the score of APACHEⅡ were 6. 3±2.0, time to abdominal pain cessation was (4±2) d, length of hospital stay was (18±5)d, medical costs was (42 000±18 000) yuan; while the corresponding values in the group B were (491±81)U/ml, (43.5±11.0) mg/L, 9.1±1.8, (8±3)d, (34±8)d, (71 000±26 000)yuan, and the difference was statistically significantly (P<0.05). Conclusions Qingyi Decoction and clyster with rhubarb should be given in the early phase of SAP in order to achieve better outcomes.