术前大承气汤加味直肠滴入对胃癌患者术后胃肠功能及炎性反应状态的影响  

Effect of Preoperative Dachengqi Decoction on Gastrointestinal Function and Inflammatory Response in Patients with Gastric Cancer

作　　者：李想[1] 张楠[1] 张静蕾 黄晶晶 张鹤[1] 陈丽嫣 孙维义 LI Xiang;ZHANG Nan;ZHANG Jinglei;HUANG Jingjing;ZHANG He;CHENG Liyan;SUN Weiyi(Affiliated Hospital of Henan University of Traditional Chinese Medicine,Henan Zhengzhou 450003,China;Zhengzhou University,Henan Zhengzhou 450001,China)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450003 [2]郑州大学,河南郑州450001

出　　处：《中医药临床杂志》2020年第10期1910-1913,共4页Clinical Journal of Traditional Chinese Medicine

基　　金：河南省中医管理局国家中医临床研究基地科研专项(2018JDZX049);河南省中医药科学研究专项课题(2019ZY2029)。

摘　　要：目的:通过大承气汤加味术前直肠滴入灌肠给药,探讨其对胃癌患者术后胃肠功能、炎性反应状态的影响。方法:选择该院2017年10月—2019年12月胃癌手术患者90例作为研究对象,随机分为中药治疗组(大承气汤加味直肠给药组)46例,对照组(温生理盐水对照组)44例。术后分别给予术后常规处理,均采用特制深褐色灌肠器,中药治疗组200mL术前连续3d直肠滴入灌肠,对照组200mL术前连续3d直肠滴入灌肠。分别记录两组术后首次肛门排气时间、首次排便时间、腹胀缓解时间、术后(24h、48h、72h)疼痛评分;检测血清炎性因子C反应蛋白(CRP)、白细胞介素(IL-6)、肿瘤坏死因子(TNF-a)。结果:中药治疗组患者术后肠鸣音恢复时间(32.14±12.33h)、首次肛门排气时间(40.22±13.41h)、腹胀缓解时间(36.14±11.25h)、首次排便时间(53.41±16.22h),对照组患者肠鸣音恢复时间(59.21±22.22h)、首次肛门排气时间(63.42±13.52h)、腹胀缓解时间(57.56±25.45h)、首次排便时间(76.56±18.13h),中药治疗组均明显短于对照组(P<0.05)。两组患者术后8、24、48h疼痛评分,中药治疗组均明显低于对照组(P<0.05)。中药治疗组灌肠患者术后炎性指标CRP、IL-6、TNF-a水平明显低于对照组(P<0.05)。结论:胃癌患者术前应用大承气汤直肠给药灌肠能明显促进患者术后胃肠道功能的恢复,显著降低患者术后炎症因子的水平,极大的加速了患者术后康复进程,有着十分重要的临床实用价值。Objective:To explore the effect of Dachengqi decoction on the gastrointestinal function and inflammatory reaction state of patients with gastric cancer after the operation of the rectum infusion.Methods:From October 2017 to December 2019,90 patients undergoing gastric cancer surgery in the hospital were selected as the research objects,and they were randomly divided into a traditional Chinese medicine treatment group(Dachengqi decoction plus flavour rectal administration group)46 cases,and a control group(warm normal saline control)Group)44 cases.Postoperative routine treatments were given after the operation,and special dark brown enema was used.In the traditional Chinese medicine treatment group,200 mL was instilled into the enema for 3 consecutive days before the operation,and 200 mL in the control group was instilled into the enema for 3 consecutive days before the operation.The first anal exhaust time,first defecation time,abdominal distension relief time,postoperative pain score(24h,48h,72h)were recorded in the two groups respectively;serum inflammatory factor C-reactive protein(CRP)and interleukin(IL-6)Tumor Necrosis Factor(TNF-α).Results:Postoperative bowel sounds recovery time(32.14±12.33h),first anal exhaust time(40.22±13.41h),abdominal distension relief time(36.14±11.25h),first defecation time(53.41±16.22h),the recovery time of bowel sounds in the control group(59.21±22.22h),the first anal exhaust time(63.42±13.52h),the time to relieve abdominal distension(57.56±25.45h),the first defecation time(76.56±18.13h),Chinese medicine The treatment group was significantly shorter than the control group(P<0.05).The pain scores of the two groups of patients at 8,24,and 48 hours after surgery were significantly lower in the traditional Chinese medicine treatment group than in the control group(P<0.05).The levels of inflammatory indexes CRP,IL-6 and TNF-αin the enema patients in the traditional Chinese medicine treatment group were significantly lower than those in the control group(P<0.05).Conclusion:Pre

关 键 词：胃癌术前 大承气汤 中药直肠滴入 胃肠功能 炎症因子 

分 类 号：R459.4[医药卫生—治疗学]