大黄牡丹皮汤口服联合复方大承气汤保留灌肠在急性化脓性腹膜炎术后的应用  被引量:5

Clinical application of Dahuang Mudanpi Tang and Fufang Dachengqi Tang retention enema for postoperative acute suppurative peritonitis

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作  者:易剑锋[1,2] 叶蓁蓁[1] 蒋文杰[2] 易华[2] 赵春霖[2] 董小鹏[1,2] 潘海邦[1,2] 

机构地区:[1]甘肃中医药大学临床医学院,甘肃兰州730000 [2]甘肃中医药大学附属医院外科,甘肃兰州730020

出  处:《甘肃中医药大学学报》2017年第4期54-58,共5页Journal of Gansu University of Chinese Medicine

基  金:甘肃省科技支撑计划项目(144FKCA073)

摘  要:目的观察大黄牡丹皮汤口服联合复方大承气汤保留灌肠在急性化脓性腹膜炎(ASP)术后的安全性及临床疗效。方法回顾性分析在甘肃中医药大学附属医院诊治的212例ASP患者的临床资料,按治疗方法不同分为普通快速康复外科理念(FTS)组(110例)和中医FTS组(102例)2组。普通FTS组采用FTS指导下的围术期处理方法,中医FTS组在普通FTS组处理方法的基础上术后联合大黄牡丹皮汤口服、复方大承气汤保留灌肠治疗。2组均以1周为1个疗程,1个疗程后比较2组患者的肠鸣音恢复时间、首次排气及排便时间、开始进食时间、体温恢复正常时间、白细胞计数恢复正常时间、腹腔引流时间、住院时间及并发症发生情况。结果中医FTS组可显著缩短术后肠鸣音恢复时间、排气及排便时间、开始进食时间、体温恢复正常时间、白细胞计数恢复正常时间、腹腔引流时间及住院时间,与普通FTS组比较差异均有统计学意义(P<0.05或P<0.01);普通FTS组并发症总发生率为17.27%,中医FTS组为8.82%,2组比较差异有统计学意义(P<0.05);2组患者在治疗过程中均未见明显不良反应。结论大黄牡丹皮汤口服联合复方大承气汤保留灌肠在ASP患者术后治疗中有利于胃肠功能的恢复、感染及炎症的控制,能加速患者的康复,减少并发症的发生。Objective To evaluate the clinical effect and safety of Dahuang Mudanpi Tang for oral administra- tion and retention enema with Fufang Dachengqi Tang for the postoperative fast recovery of acute suppurative perito- nitis (ASP). Methods Based on the retrospective analysis of clinical data of 212 ASP cases in the hospital Ap- piliated to Gansu University of Chinese Medicine, the patients were divided into normal fast track surgery (FTS) group (110 cases) and TCM FTS group (102 cases). The normal FTS group was intervened with perioperative pe-riod therapy according to FTS. Based on that, the TCM FFS group was treated with Dahuang Mudanpi Tang for oral administration and retention enema with Fufang Dachengqi Tang additionally. One week was as a course. Intestinal sound recovery time, first exhaust and defecation time, eating time, recovery time of body temperature, leukocyte count, intraperitoneal drainage time, hospitalization time and complications were observed and conapared between the two groups after one course. Results Intestinal sound recovery time, first exhaust and defecation time,eating time, recovery time of body temperature,leukocyte count recovery time,intrapefitoneal drainage time, hospitalization time recorded in TCM FTS group were all shorter than that in normal FTS group, the difference was statistically signifi- cant ( P〈O. 05 or P〈0.01 ). The overall incidence of complications of TCM FTS group (8.82%) was much lower than that of normal FTS group ( 17.27% ), the difference was significant ( P〈0.05 ). No serious adverse reactions were found in two groups. Conclusion The combined therapy is effective in recovering gastrointestinal function and controlling inflammation as well as infection. It can promote rehabilitation and reduce complications.

关 键 词:急性化脓性腹膜炎 快速康复外科 大黄牡丹皮汤 复方大承气汤 临床观察 

分 类 号:R259.722[医药卫生—中西医结合]

 

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