保和汤加减在全胃切除术后肠功能恢复中的效果研究  

Clinical study on the recovery of intestinal peristalsis treated with Baohe Decoction in postoperative patient with gastric cancer

作　　者：刘鸿芹[1] 郭剑民[2] 杨芳[2] 张锐[1] LIU Hong-qin;GUO Jian-min;YANG Fang(Department of Thoracic Surgery,Zhejiang Cancer Hospital,Hangzhou,Zhejiang 310022,China)

机构地区：[1]浙江省肿瘤医院胸部肿瘤外科,浙江杭州310022 [2]浙江省肿瘤医院腹部肿瘤外科

出　　处：《中华全科医学》2019年第11期1907-1910,共4页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2015KYB069)

摘　　要：目的探讨保和汤加减在全胃切除术后肠功能恢复中的作用。方法选取浙江省肿瘤医院2015年7月-2017年6月病理证实为胃癌并行全胃切除患者,共120例,根据随机数字表法分为试验组和对照组,各60例,试验组术后24 h内开始每日2次给予保和汤加减200 mL鼻饲,对照组给予200 mL生理盐水鼻饲,连续3 d;比较2组间术后排气、排便时间,术后腹压,术后血清生长抑素、胆囊收缩素以及IL-6浓度的差异。结果试验组术后排气时间[(3.20±0.73)d vs.(3.58±0.92)d]、排便时间[(4.40±0.85)d vs.(4.87±1.35)d]均短于对照组;试验组术后腹压D1[(10.38±3.51)cm H2O(1 cm H2O=0.098 kPa)vs.(13.47±6.51)cm H2O],D2[(11.57±4.43)cm H2O vs.(13.46±5.58)cm H2O],D3[(10.15±4.41)cm H2O vs.(12.06±4.98)cm H2O],均低于对照组;试验组术后D7的血清生长抑素浓度[(17.09±6.66)pg/mL vs.(20.36±9.76)pg/mL]以及血清IL-6浓度[(11.53±4.13)pg/mL vs.(13.69±5.89)pg/mL]低于对照组;术后D7的血清胆囊收缩素浓度[(110.18±53.21)pg/mL vs.(70.42±31.97)pg/mL]高于对照组;2组血清胆囊收缩素、IL-6以及生长抑素浓度在术后D0、D1及D3的差异无统计学意义。结论保和汤加减应用于全胃切除手术的患者,具有明显促进肠道功能恢复的作用。Objective To investigate the role of Jiajian Baohe Decoction in the recovery of intestinal function after total gastrectomy.Methods A total of 120 patients with pathologically confirmed gastric cancer and total gastrectomy in Zhejiang Cancer Hospital from July 2015 to June 2017 were enrolled.According to the random sequence number,the study group and the control group were divided into 60 cases.The study group began to give Jiajian Baohe Decoction 200 mL nasal feeding twice a day within 24 hours for 3 consecutive days,and the control group was given 200 mL saline nasal feeding.The postoperative venting and defecation time,postoperative abdominal pressure,postoperative serum concentration of somatostatin,cholecystokinin and IL-6 were compared between the two groups.Results The postoperative venting time(3.20±0.73)d vs.(3.58±0.92)d and defecation time(4.40±0.85)d vs.(4.87±1.35)d in the study group were shorter than those in the control group.The postoperative abdominal pressure of study group on D1(10.38±3.51)cm H2O vs.(13.47±6.51)cm H2O,D2(11.57±4.43)cm H2O vs.(13.46±5.58)cm H2O,D3(10.15±4.41)cm H2O vs.(12.06±4.98)cm H2O was lower than that of the control group.The serum concentration of somatostatin(17.09±6.66)pg/mL vs.(20.36±9.76)pg/mL and IL-6(11.53±4.13)pg/mL vs.(13.69±5.89)pg/mL on postoperative D7 in the study group lower than that of the control group.And the serum cholecystokinin(CCK)concentration of postoperative D7(110.18±53.21)pg/mL vs.(70.42±31.97)pg/mL In the study group was higher than that of the control group.There were no significant differences in the serum concentration of CCK,IL-6 and somatostatin on postoperative D0,D1 and D3 between the two groups.Conclusion The Jiajian Baohe Decoction in patients undergoing total gastrectomy has a significant effect on the recovery of intestinal function.

关 键 词：全胃切除术 保和汤加减 肠功能 

分 类 号：R735.2[医药卫生—肿瘤]