中药灌肠联合生大黄穴位贴敷用于重症急性胰腺炎并发麻痹性肠梗阻的效果观察  

Effect of traditional Chinese medicine enema combined with rhubarb acupoint in the treatment of severe acute pancreatitis complicated with paralytic ileus

作　　者：温培英[1] 徐永强[1] 方美珍[1] 陈建英[1] Wen Peiying;Xu Yongqiang;Fang Meizhen;Chen Jianying(Department of General Surgery,the First Peoples Hospital of Huzhou.Huzhou.Zhejiang 313000,China)

机构地区：[1]湖州市第一人民医院普外科,浙江省313000

出　　处：《中国基层医药》2019年第11期1281-1284,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省医药卫生科技计划(2016ZDA017).

摘　　要：目的观察中药灌肠联合生大黄穴位贴敷治疗重症急性胰腺炎(SAP)并发麻痹性肠梗阻的临床效果。方法选择湖州市第一人民医院2015年6月至2017年6月治疗的SAP并发麻痹性肠梗阻患者60例为研究对象,采用随机抽签法分为对照组30例、观察组30例。两组患者均进行常规抗感染、补液等治疗,对照组采用中药灌肠联合安慰剂贴敷神阙穴治疗,观察组采用中药灌肠联合生大黄贴敷神阙穴治疗,两组疗程均为7 d。观察两组血淀粉酶恢复正常时间、肠鸣音恢复时间、首次自行排便时间、局部并发症、病死率。结果观察组血淀粉酶恢复正常时间、肠鸣音恢复时间、首次排便时间分别为(8.87±2.30)d、(2.88±1.09)d、(3.51±1.32)d,均显著短于对照组的(10.29±2.01)d、(3.67±1.30)d、(4.57±1.41)d,差异均有统计学意义(t=-3.601、-3.607、-4.251,均P<0.001);观察组局部并发症发生率为6.7%(2/30),明显低于对照组的36.7%(11/30)(χ^2=16.875,P<0.001);两组病死率差异无统计学意义(χ^2=3.333,P=0.068)。结论中药灌肠联合生大黄穴位贴敷能有效促进肠蠕动的恢复,缩短麻痹性肠梗阻的持续时间,减少并发症,提高临床疗效。Objective To observe the clinical effect of traditional Chinese medicine enema combined with rhubarb acupoint in the treatment of severe acute pancreatitis(SAP)complicated with paralytic ileus.Methods A total of 60 SAP patients complicated with paralytic ileus treated in the First People's Hospital of Huzhou from June 2015 to June 2017 were selected and randomly divided into two groups by random lottery method,with 30 cases in each group.The two groups were treated with routine anti-infection and rehydration.The control group was treated with traditional Chinese medicine enema combined with placebo,and the observation group was treated with traditional Chinese medicine enema combined with rhubarb on Shenque acupoint,and the two groups were treated for 7d.The recovery time of blood amylase,bowel sounds recovery time,first self defecation time,local complications and mortality were observed in the two groups.Results The recovery time of blood amylase,the recovery time of intestinal sound and the time of the first defecation were(8.87±2.30)d,(2.88±1.09)d and(3.51±1.32)d,respectively,which were significantly shorter than those of the control group[(10.29±2.01)d,(3.67±1.30)d and(4.57±1.41)d],the differences were statistically significant(t=-3.601,-3.607,-4.251,all P<0.001).The incidence rate of local complications in the observation group was 6.7%(2/30),which was significantly lower than 36.7%(11/30)in the control group(χ^2=16.875,P<0.001),and there was no statistically significant difference in the mortality rate between the two groups(χ^2=3.333,P=0.068).Conclusion The application of Chinese medicine enema combined with the acupoint of rhubarb in the treatment of SAP patients complicated with paralytic ileus can effectively promote the recovery of intestinal peristalsis,shorten the duration of paralytic intestinal obstruction,reduce the complications and improve the clinical effect.

关 键 词：胰腺炎 肠梗阻 灌肠 针刺穴位 透皮贴剂 中草药 

分 类 号：R657.51[医药卫生—外科学] R574.2[医药卫生—临床医学]