大承气汤保留灌肠对胃肠手术患者炎症因子及肛门排气的影响  

Effect of Dachengqi Decoction Retention Enema on Inflammatory Factors and Anal Exhaust in Patients Undergoing Gastrointestinal Surgery

作　　者：郅树升 ZHI Shusheng(Zhoukou Hospital of Traditional Chinese Medicine,Zhoukou 466000,Henan,China)

机构地区：[1]周口市中医院,河南周口466000

出　　处：《实用中医内科杂志》2020年第8期35-38,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：河南省高等学校重点计划(15A360002)。

摘　　要：目的探讨大承气汤保留灌肠对胃肠手术患者炎症因子及肛门排气的影响。方法选择2017年1月—2018年9月在医院进行胃肠手术治疗的患者68例,采用随机数字表法分为观察组和对照组各34例。术后两组均予以术后禁饮禁食,并给患者静脉补充氨基酸、维生素等,进行持续胃肠减压。对照组术后6 h给予20 m L开塞露,观察组术后12 h给予大承气汤保留灌肠,水煎200 m L,待温度降至38~40℃,用润滑液润滑肛门,插入肛滴管10~15 cm,20 min滴完,抽出肛管,并让患者平卧1 h。两组均每24 h保留灌肠1次,直到患者排便,即停止。比较两组治疗后患者炎症因子(C反应蛋白、肿瘤坏死因子-α、白细胞介素-6)、肠鸣音恢复正常时间、饮食恢复时间、首次肛门排气时间、首次排便及肠鸣音评分。结果治疗后,观察组后C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)均低于对照组(P <0.05);观察组肠鸣音恢复正常时间、饮食恢复时间、首次肛门排气时间、首次排便时间均短于对照组(P <0.05);观察组术后18 h、24 h时肠鸣音评分低于对照组(P <0.05)。结论大承气汤保留灌肠有助于改善胃肠手术患者术后炎症因子水平,促进肛门排气、排便及肠鸣音恢复,使患者及早进食,改善胃肠功能。Objective To investigate the effect of Dachengqi decoction retention enema on inflammatory factors and anal exhaust in patients undergoing gastrointestinal surgery. Methods Sixty-eight patients who underwent gastrointestinal surgery in our hospital from January 2017 to September 2018 were selected and divided into observation group and control group with 34 cases in each group. After operation,the patients in both groups were forbidden to drink and eat,and were given amino acids and vitamins to continue gastrointestinal decompression. In the control group,Kaiselu( 20 m L) was given 6 h after operation.In the observation group,Dachengqi was given for enema 12 h after operation. The decoction was 200 m L,and when the temperature dropped to 38 ~ 40 ℃,the anus was lubricated with lubricating fluid,10-15 cm of anal dropper was inserted,and the dripping was completed within 20 min. The anal tube was drawn out and the patient was lying on his back for 1 h. Enema was kept every 24 hours in both groups until defecation stopped. The inflammatory factors( C-reactive protein,tumor necrosis factor-α,interleukin-6),the recovery time of bowel sounds,the recovery time of diet,the first time of anal exhaust,the first time of defecation and the score of bowel sounds were compared between the two groups. Results After treatment,C-reactive protein( CRP),tumor necrosis factor-α( TNF-α) and interleukin-6( IL-6) in the observation group were lower than those in the control group. There was significant difference between the two groups( P < 0. 05). Conclusion Dachengqi decoction retention enema is helpful to improve the levels of inflammatory factors,promote the recovery of anal exhaust,defecation and bowel sounds,making patients eat early and improve gastrointestinal function.

关 键 词：胃肠手术 大承气汤 灌肠 开塞露 C反应蛋白 肿瘤坏死因子-α 白细胞介素-6 肠鸣音 肛门排气 肛门排便 

分 类 号：R289[医药卫生—方剂学]