枳实通降颗粒对结直肠肿瘤患者术后胃肠功能恢复及术后早期炎性肠梗阻防治作用的双中心前瞻性研究  

Zhishi Tongjiang Granule( 枳实通降颗粒) on Postoperative Gastrointestinal Function Restoration and Prevention & Treatment on Early Postoperative Inflammatory Ileus in Patients with Colorectal Carcinoma: A Double Center Prospective Study

作　　者：莫黎[1] 何永恒 康安定[3] 徐亚琨[3] 周平兰 罗敏 彭雅莉 陈赛[1] MO Li HE Yongheng KANG Anding XU Yakun ZHOU Pinglan LUO Min PENG Yali CHEN Sai(Hunan University of Chinese Medicine, Hunan 410208 Chinese Medicine Hospital of Hunan Province Hunan Cancer Hospital)

机构地区：[1]湖南中医药大学,湖南省长沙市含浦科教园区410208 [2]湖南省中医院 [3]湖南省肿瘤医院

出　　处：《中医杂志》2017年第20期1760-1763,共4页Journal of Traditional Chinese Medicine

摘　　要：目的评价枳实通降颗粒对结直肠肿瘤患者术后胃肠功能恢复及术后早期炎性肠梗阻防治的有效性及安全性。方法采用多中心前瞻性随机双盲对照方法,将结直肠肿瘤手术患者197例分为试验组98例,对照组99例。两组患者围手术期均给予常规治疗,试验组于术后6~12 h开始少量多次口服或经胃管给予枳实通降颗粒(制成50 ml药液),每日1剂。对照组仅口服等量安慰剂。记录患者肠鸣音恢复时间、首次排气时间、首次排便时间、首次进食固体食物时间、住院天数、肠梗阻发生情况,并记录不良反应及并发症发生情况,观察安全性指标变化。结果试验组术后肠鸣音恢复时间、首次排气时间、首次排便时间及首次进食固体食物时间均较对照组明显缩短(P<0.01)。对照组6例发生术后早期炎性肠梗阻,试验组4例。试验组平均住院时间(14.00±0.82)天,显著短于对照组的(19.33±3.98)天(P<0.05)。两组并发症及肝肾功能异常发生情况比较,差异均无统计学意义(P>0.05)。术后第5天试验组降钙素原下降较对照组明显(P<0.05)。结论枳实通降颗粒可促进结直肠肿瘤胃肠道手术后患者胃肠功能恢复,并对术后早期炎性肠梗阻有一定的防治作用,且安全性好。Objective To evaluate the efficiency and safety of Zhishi Tongjiang Granule on postoperative gastrointestinal function restoration and prevention treatment of early postoperative inflammatory ileus in patients with colorectal carcinoma. Methods Multicentric prospective randomized double-blind control method was adopted.One hundred and ninety-seven patients with colorectal carcinoma for surgery were divided into an experimental group（ 98 patients）,and a control group（ 99 patients）. During the perioperative period,both groups were given routine treatment. At 6 to 12 h after operation,the experimental group began to take Zhishi Tongjiang Granule（ made into50 ml liquor） orally or through nasogastric tube with small amount frequently,one dose a day. The control group was only given placebo of equal volume. Recovery time of bowel sounds,the first exhaust time,first defecation time,first solid food time,length of hospital stay,and the incidence of intestinal ileus,as well as the occurrence of adverse reactions and complications were recorded. The safety index changes were also observed. Results The postoperative recovery time of bowel sounds,the first exhaust time,first defecation time and the first solid food time in the experimental group were significantly shorter than those in the control group（ P〈0. 01）. Six cases in the control group and 4 cases in the experimental group had early postoperative inflammatory ileus. The average length of hospital stay in the experimental group was（ 14 ＋ 0. 82） days,which was significantly shorter than（ 19. 33 ＋ 3. 98） days in the control group（ P〈0. 05）. There were no significant differences in rate of complications and incidence of abnormal liver function between the two groups（ P〈0. 05）. On the fifth day after operation,levels of procalcitonin decreased more significantly in the experimental group compared with that in the control group（ P〈0. 05）. Conclusion Zhishi Tongjiang Granule could promote the recovery of gastrointestinal func

关 键 词：结直肠肿瘤 术后早期炎性肠梗阻 胃肠功能 枳实通降颗粒 

分 类 号：R273[医药卫生—中西医结合]