Name: enema of traditional chinese medicine for patients with severe acute pancreatitis
Uploaded: 2023-01-27T13:45:00
Description: Watch this Scientific Journal Video about Enema of Traditional Chinese Medicine for Patients with Severe Acute Pancreatitis at JoVE.com

这项工作得到了四川省中医药管理局中医药专项研究项目（2021MS417）的支持。

临床方案已获得成都中医药大学附属医院重症医学科管委会批准（备案号：KY20221005）。实验程序按照成都中医药大学医院指南进行。手术需要签署知情同意书的患者的同意。在进行灌肠之前，操作员应了解直肠的解剖结构并查看解剖注释（见 图3）。
1.操作人员的治疗前准备
<ol><li>包括有主要症状（即持续性上腹部疼痛）的患者。</li>
	<li>...

<ol>
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AP是一种炎症性疾病，可以进展为SAP。根据大量研究，SAP是一种毁灭性疾病，死亡率从不到10%到高达85%不等，尽管近十年死亡率有所下降33。SAP严重影响患者的生活质量，如果不及时有效地治疗，甚至可能导致死亡。积极有效的早期治疗具有临床意义34。
中草药灌肠在治疗SAP方面有很多优点。灌肠通过直肠吸收，吸收完全，生物利用度高，?...

急性胰腺炎（AP）是一种急性腹部疾病，其特征在于胰腺酶异常激活引起的局部胰腺炎症反应，胰酶对胰腺和周围器官具有消化作用1。作为美国住院最普遍的胃肠道原因之一，急性胰腺炎需要越来越多的关注，因为它在世界范围内继续增加2，3。在过去的十年中，对急性胰腺炎病理生理机制的认识取得了重大进展4，5，6。约5%-10%的急性胰腺炎病例与严重器官功能障碍有关;这种类型的胰腺炎被定义为严重急性胰腺炎（SAP）7。早期西医治疗AP一般包括液体治疗、镇痛、营养支持、病因治疗和早期并发症。然而，西医治疗现阶段仍缺乏针对AP的特效药物8，9，10。
在传统中医（TCM）中，AP被称为“腹痛”，“皮心通”和“胰热”。中医灌肠疗法是中医最常用的治疗方法之一，可以追溯到汉11世纪张仲京《感冒致病论》中的蜂蜜汤法。其临床疗效已被记录用于治疗溃疡性结肠炎12、高尿酸血症13、急性放射性直肠炎 14、急性肾损伤15 和肠道 SARS-CoV-216。
近年来，中药灌肠（大黄17，18，米拉比石19，以及青衣汤20和大成奇汤21等复方制剂）在SAP的临床和实验研究中得到了广泛的应用。它已被证明可以保护胰腺功能，减轻腹痛和腹胀，并延缓疾病进展22，23。2021 年中国 AP 诊断和治疗指南包括中药灌肠24.然而，目前尚不清楚中药灌肠应如何用于SAP患者。因此，我们提出了一种进行中药灌肠的方案，为研究民族药物在SAP患者治疗中的成分和机制提供了一种有效的方法25。

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			<td>Shenzhen Chenzhou Technology Co., Ltd.</td>
			<td>TP300</td>
			<td></td>
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enema of traditional chinese medicine for patients with severe acute pancreatitis

严重急性胰腺炎（SAP）的特点是死亡率高，并发症多，治疗难度大。中药灌肠剂已广泛应用于SAP的临床和实验研究。它已被证明在保护胰腺功能和延缓疾病进展方面具有有益作用。中药灌肠的程序是灌注生大黄（大黄）的中药液。大黄）从肛门进入直肠和结肠。该程序的基本步骤包括提前煮沸草药溶液，使用一次性灌肠试剂盒帮助患者采取左躺姿势，将患者的臀部抬高10厘米，并小心地将灌肠剂插入肛门30-35厘米，滴速为60-80滴/分钟。药液温度应与患者的体温相当，通常在37-39°C之间。 灌肠手术的结束应该是缓慢的，拔管前应给予推拿（按摩疗法）。药液应在直肠中保存1小时以上。灌肠后，必须观察患者的粪便和腹部，并评估腹部体征和症状的缓解。

在这项研究中，患者因反复上腹部疼痛而入院。根据诊断标准30，患者被诊断为SAP。在患者接受该方案治疗后，有明显的治疗效果31。
患者A，女性，84岁，于2019年5月2日首次确诊。患者主诉反复上腹部腹胀和疼痛。临床检查显示，血清淀粉酶为509 U/L（参考值：35-135 U/L），尿淀粉酶为1，343 U/L（参考值：0-600 U/L）。体格检查显示腹部肿胀，全...

Watch this Scientific Journal Video about Enema of Traditional Chinese Medicine for Patients with Severe Acute Pancreatitis at JoVE.com

Enema of Traditional Chinese Medicine for Patients with Severe Acute Pancreatitis

灌肠是一种用于治疗严重急性胰腺炎 （SAP） 的传统中药 （TCM） 疗法。该疗法包括通过肛门将中药液体滴入直肠和结肠，以将液体保持在肠道中，并通过肠粘膜吸收。本研究旨在规范SAP患者的灌肠程序。

重症急性胰腺炎患者中药灌肠

Severe acute pancreatitis (SAP) is characterized by high mortality rates, numerous complications, and extreme difficulties in treatment. A traditional ...

所展示的中药灌肠方案为研究治疗严重急性胰腺炎患者的胸道和美加林提供了一种原型方法。由于灌肠通过直肠吸收，因此具有完全吸收和高生物利用度。直肠给药简单，副作用少，给药方便。灌肠可以保护胰腺功能，减轻腹痛和腹胀，延缓疾病进展。包括2021年中国急性胰腺炎诊疗指南——最重要的是，应牢记指标和禁忌指标，该过程必须在您医院超级医生的指导下进行。检查患者的基本信息，包括姓名、年龄和医院编号。验证患者的病情并重新评估。向患者解释灌肠的过程和优点，确保他们能够充分理解和放松。将室温调节在 18 至 28 摄氏度之间。准备好所有必要的物品，并在检查材料的有效期后，将它们带到床边。关闭所有门窗，确保患者不会不必要地暴露并保持温暖。接下来，洗手并擦干双手，戴上一次性手套，并使用床边的温度计测量灌肠液的温度。协助患者采取左侧卧位。如有必要，根据病情选择右侧卧位。完全暴露肛门，将治疗床单的中心放在臀部下方，并使用枕头将臀部抬高 10 厘米。然后用石蜡油润滑肛管前端，并在暴露肛门之前从肛门排出石蜡油。以每分钟60至80滴的滴速将液体药物的温度调整为与患者的体温相当，确保液位距肛门不超过35厘米。随后，关闭一次性灌肠套件的塞子夹，并将液体倒入套件的悬挂袋中。指导患者在插入肛管时张开嘴呼吸，以放松肛门，促进肛管的顺利插入。接下来，用一次性套件中的塑料软管将肛管插入 30 到 35 厘米。打开塞子夹，慢慢滴入液体 15 到 20 分钟。根据患者的病情调整滴速。在输液过程中，不断监测和询问患者的耐受性。在不适或方便的情况下调整输液速率，必要时停止输液。在拔管塑料软管之前，将指尖放在肛周皮肤上，以圆周运动轻轻来回揉捏以放松肛门周围的肌肉。施用药物后，其剂量不应超过200毫升，夹紧并从肛管中取出塑料软管。完成后，用纱布轻轻摩擦肛门，帮助患者干燥肛周皮肤，并帮助患者采取舒适的躺卧姿势，臀部抬高。如果在手术的任何部分，患者脉搏缓慢，脸色苍白，出冷汗，严重腹痛或心悸，请立即停止并联系医生。在被诊断为严重急性胰腺炎的患者中，在用灌肠治疗后观察到显着的治疗效果，灌肠是一种使用生大黄液体提取物的传统中药疗法。例如，在主诉反复上腹部扩张和疼痛的 84 岁女性患者中，血清淀粉酶为 509 单位/升，而参考值为 35 至 135 单位/升。血清淀粉酶在每两小时给予一次灌肠治疗和常规西药治疗后降至每升216单位。在继续相同的治疗后，水平降至每升95单位，之后灌肠频率降低。其他人也注意到了类似的效果。当对照组与实验患者进行比较时，治疗的临床疗效是显而易见的。最重要的是向患者询问其他疾病，例如禁忌症，皮肤状况和精神合作状态。也可以根据不同的情况调整中药，使用正确的乡村治疗药物。这种治疗方法自汉代以来就已经发展起来，我们已经合成了它，希望将这项技术带到医院。

Research

JoVE Journal

Medicine

Semi-quantitative Assessment Using [18F]FDG Tracer in Patients with Severe Brain Injury

Semi-quantitative Assessment Using [18F]FDG Tracer in Patients with Severe Brain Injury

[18f] fdg 示踪剂在重型颅脑损伤患者中的半定量评价

Patients with severe traumatic brain injury (sTBI) have difficulty knowing whether they are accurately expressing their thoughts and emotions because of ...

科研

医学

Sodium Taurocholate Induced Severe Acute Pancreatitis in C57BL/6 Mice

牛磺胆酸钠诱导C57BL / 6小鼠严重急性胰腺炎

Biliary acute pancreatitis induction by sodium taurocholate infusion has been widely used by the scientific community due to the representation of the ...

Fertility Preservation in Patients with Severe Ovarian Dysfunction

严重卵巢功能障碍患者的生育保护

Ovarian function progressively declines during aging and in some pathophysiological conditions including karyotype abnormality, autoimmune diseases, ...

Establishment of a Mouse Severe Acute Pancreatitis Model using Retrograde Injection of Sodium Taurocholate into the Biliopancreatic Duct

建立小鼠重症急性胰腺炎模型，将牛磺胆酸钠逆行注射到胆胰管中

The prevalence of acute pancreatitis (AP), especially severe acute pancreatitis (SAP), is increasing in younger age groups annually. However, there is a ...

Visualization of Metabolites Identified in the Spatial Metabolome of Traditional Chinese Medicine Using DESI-MSI

使用DESI-MSI鉴定中药空间代谢组中代谢物的可视化

The medicinal use of traditional Chinese medicine is mainly due to its secondary metabolites. Visualization of the distribution of these metabolites has ...

Using Multiple Light Scattering to Examine the Stability of Phyllanthus emblica L. Extracts Obtained with Different Extraction Methods

Using Multiple Light Scattering to Examine the Stability of Phyllanthus emblica L. Extracts Obtained with Different Extraction Methods

使用多重光散射检查不同提取方法获得的余 甘子 L.提取物的稳定性

The extraction intermediate of traditional Chinese medicine is the key intermediate in the preparation process, and its stability has an important impact ...

A Method for Zanba-Stir-Fried Tiebangchui Process Optimization

Optimization of Processing Technology for Tiebangchui with Zanba Based on CRITIC Combined with Box-Behnken Response Surface Method

Optimization of Processing Technology for Tiebangchui with Zanba Based on CRITIC Combined with Box-Behnken Response Surface Method (Video) | JoVE 

基于CRITIC结合Box-Behnken响应面法的铁邦岀与赞坝加工工艺优化

The dried root of Aconitum pendulum Busch., called Tiebangchui (TBC) in Chinese, is one of the most famous Tibetan medicines. It is a widely used herb in ...

A Traditional Chinese Medicine Characteristic Therapy for Bronchial Asthma: Moxibustion

支气管哮喘的中医特色疗法：艾灸

Bronchial asthma is a chronic inflammatory disease of the airway which can lead to symptoms such as recurrent wheezing, shortness of breath, chest ...

Acupoint Needle-Embedding Combined with Ironing Therapy for Postoperative Pain After Anal Surgery

穴位嵌入联合熨烫治疗肛门术后疼痛

Acupoint needle-embedding combined with ironing therapy is a non-drug treatment method to release postoperative pain after anal surgery. The practice is ...

Standardized Tuina Protocol for Rat DRG Compression Model

Analgesic Effect of Tuina on Rat Models with Compression of the Dorsal Root Ganglion Pain

Analgesic Effect of Tuina on Rat Models with Compression of the Dorsal Root Ganglion Pain (Video) | JoVE 

推拿对大鼠模型的镇痛作用，压迫背根神经节疼痛

Neuropathic pain is a prevalent condition that affects 6.9%-10% of the population and results from nerve damage due to various etiologies, such as lumbar ...