自拟肠粘连缓解汤加泛影葡胺治疗粘连性肠梗阻的疗效观察  

Clinical Observation of Utilizing Self-Made "Ankylenteron Alleviating Decoction" Plus Angiografin on Adhesive Ileus

作　　者：张建宇[1] 傅颖[1] 

机构地区：[1]绍兴文理学院附属医院,浙江绍兴312000

出　　处：《中华中医药学刊》2008年第10期2291-2293,共3页Chinese Archives of Traditional Chinese Medicine

摘　　要：目的：观察自拟肠粘连缓解汤加泛影葡胺治疗粘连性肠梗阻的临床应用效果。方法：96例粘连性肠梗阻患者随机分为治疗组64例与对照组32例。对照组给予禁食、持续胃肠减压、输液、补充电解质、维持酸碱平衡、应用广谱抗生素及654—2等基本治疗；治疗组除上述基本治疗外，另将76％泛影葡胺60～100mL与100mL中药混合后经胃管注入，此后每隔8h由胃管注入中药100—150mL，每次注药后夹管2h再开放继续胃肠减压。从第1次注药后开始严密观察病情变化，每隔6～8h经x线透视或摄片评价疗效，若症状不缓解或有恶化趋势则及时转外科手术。结果：治疗组有效59例，有效率92．19％；第1次排便时间平均为（18．36±11．58）h；无效的5例病人中转手术治疗，无1例肠管绞窄坏死及死亡。对照组有效23例，有效率71．88％；第1次排便时间平均为（27．74±14．68）h；无效的9例病人中转手术治疗，有1例肠管坏死，无死亡者。两组总有效率、第1次排便时间经检验均有显著统计学差异（P〈0．01）。结论：采用中西医结合的疗法安全有效，较一般的保守治疗明显提高非手术治愈率、减少中转手术率、缩短梗阻症状持续时间，同时它又有明确的指标为早期手术提供客观依据，因此值得临床推广应用。Objective ： To observe the clinical effects of utilizing self - made ＂ankylenteron alleviating decoction＂ plus anglografin on adhesive ileus. Methods： 96 patients with adhesive ileus were randomly divided into two groups： the control group being administered with basic treatment such as fasting, continuing gastrointestinal decompression, transfusion, supplementing electrolyte, sustaining acid - base balance, using antibiotics and 654 - 2 ; on top of the basic treatment the treatment group being administered with 60 - 100mL 76% angiografin plus 100mL Chinese herb decoction by gastric tubes infusion, and then repeating the Chinese herb decoction infusion every 8 hours. The continuing gastrointestinal decompression was being performed every two hours after the decoction infusion. Disease conditions were observed tightly by X - ray seeing through or photograph. If symptoms could not be improved or inversely be aggravated, the patient would be resorted to operation. Results： There were significant difference between the two groups on effective rate （92.19% vs 71. 88% respectively, P 〈0.01 ） and the first defecation time in those who responded to the internal treatment [ （ 18.36 ± 11.58） h vs （27.74 ± 14.68 ） h ], respectively, （ P 〈 0.01 ）. Five cases in treatment group were administered with operation midway but no one had intestinal strangulation or death; nine cases in control group were administered with operation midway and one with intestinal necrosis but no one died. Conclusion： the treatment with combining Chinese herbs and western medicine is safe and effective than the single use of western medicine, and it can promote non - surgery cure rate, reduce the midway operation rate and shorten the duration of obstruction symptoms. It also has precise indexes for early operation that it＇s worthy of clinical extending.

关 键 词：自拟肠粘连缓解汤 粘连性肠梗阻 中西医结合疗法 泛影葡胺 

分 类 号：R574.2[医药卫生—消化系统]