通里攻下法防治食管癌术后患者胃肠动力低下的临床研究  

Clinical Study on Improving Decreased Gastrointestinal Motility of Post-operative Esophageal Cancer Patients by Unblocking the Interior and Purgation Method

作　　者：葛洪霞[1] 许翠萍[2] 罗景玉[3] 

机构地区：[1]山东省肿瘤医院内科,济南250017 [2]山东大学附属千佛山医院人力资源部,济南250014 [3]山东省肿瘤医院胸外科,济南250017

出　　处：《中国中西医结合杂志》2011年第7期884-887,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：山东省中医药科技发展计划基金资助项目(No.2009-166)

摘　　要：目的观察通里攻下法防治食管癌术后胃肠动力低下的临床疗效,并探讨其作用机制。方法选择60例食管癌术后患者,随机分为试验组和对照组,每组30例。两组均给予常规治疗,试验组在常规治疗基础上给予通里攻下中药汤剂肠内营养管注入,对照组仅注入生理盐水。记录两组患者术后首次肛门排气时间、首次排便时间、肠鸣音恢复时间及术后第1～3天胃液引流总量;检测患者术前及术后第4天血浆胃动素(motilin,MTL)及血管活性肠肽(vasoactive intestinal peptide,VIP)含量。结果两组术后首次肛门排气时间、首次排便时间、肠鸣音恢复时间及胃液引流量比较,试验组均少于对照组,差异有统计学意义(P<0·05,P<0·01)。术后试验组血浆MTL含量高于对照组,VIP含量低于对照组,差异均有统计学意义(P<0·05,P<0·01)。血浆MTL及VIP含量手术前后组内比较,试验组差异无统计学意义(P>0·05),对照组差异有统计学意义(P<0·01)。结论应用通里攻下法能够显著促进食管癌术后患者胃肠动力恢复,临床疗效良好。Objective To observe the clinical effect of unblocking the interior and purgation method on improving decreased gastrointestinal motility of post-operative esophageal cancer patients,and to study its mechanisms.Methods 60 patients with post-operative esophageal cancer were randomly assigned to two groups,the treatment group and the control group,30 in each group.Routine therapies were given to the two groups.Chinese drugs with unblocking the interior and purgation action was infused by enteral nutrition tube to patients in the treatment group,while normal saline was infused to those in the control group.The first flatus time,the first defecation time,the bowel tones recovery time after operation,and the total amount of the gastric juice draining between the first day and the third day after operation of all patients were recorded.Plasma motilin（MTL） and vasoactive intestinal peptide（VIP） contents were detected before operation and the fourth day after operation.Results The first flatus time,the first defecation time,the bowel tones recovery time after operation,and the total amount of the gastric juice draining were less in the treatment group than in the control group,showing statistical difference（P0.05,P0.01）.The post-operative MTL contents were higher and VIP contents lower in the treatment group than in the control group,showing statistical difference（P0.05,P0.01）.There was no significant difference in plasmal MTL and VIP contents of the treatment group between before and after treatment（P0.05）.But there was significant difference in plasmal MTL and VIP contents of the control group between before and after treatment（P0.01）.Conclusion Unblocking the interior and purgation method could significantly promote the gastrointestinal motility recovery of post-operative esophageal cancer patients,showing good clinical effect.

关 键 词：通里攻下法 食管癌术后 胃肠动力低下 

分 类 号：R735.1[医药卫生—肿瘤]