益气通腑汤对保护性肠造口术后患者康复及营养状况的影响  

Effect of Yiqi Tongfu Decoction on Rehabilitation and Nutritional Status of Patients after Protective Enterostomy

作　　者：蔡明明[1] 杨会举[1] CAI Mingming;YANG Huiju(The Third Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450008)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008

出　　处：《中医学报》2021年第5期1093-1096,共4页Acta Chinese Medicine

基　　金：国家中医药管理局中医药创新骨干人才培训项目{国中医药人教函【2019】128号};河南省科技厅科技攻关项目(182102311146);河南中医药大学“科研苗圃工程项目”(MP2017-06)。

摘　　要：目的:分析益气通腑汤对保护性肠造口术后患者康复及营养状况的影响,以期能为临床治疗提供指导。方法:采用前瞻性分析的研究方法,对120例直肠癌患者进行研究,所有患者均采用腹腔镜低位直肠癌前切除术联合横结肠/末端回肠袢式造口术治疗。采用随机数字表法分为观察组和对照组,每组60例。观察组患者同时给予益气通腑汤。对两组患者术后各康复指标、术后7 d时各营养指标及各免疫指标、并发症情况进行比较。结果:与对照组相比,观察组术后各项康复指标水平均降低,观察组的术后7 d时各营养指标及免疫球蛋白A(immunoglobulin A,IgA)、IgG、IgM、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平均升高,CD_(8)^(+)水平降低,差异有统计学意义(P<0.05)。与对照组相比,观察组恶心呕吐、造口旁疝、伤口感染、吻合口瘘、吻合口狭窄发生率降低,差异有统计学意义(P<0.05)。结论:保护性肠造口术联合益气通腑汤能够有效改善直肠癌腹腔镜手术患者的机体营养状况,提高免疫力,促进术后恢复,且可降低各项并发症的发生率,安全性较佳。Objective:To analyze the effect of Yiqi Tongfu Decoction on rehabilitation and nutritional status of patients after protective enterostomy,in order to provide guidance for later clinical treatment.Methods:A prospective study was conducted in 120 patients with rectal cancer.All patients were treated with laparoscopic anterior resection of low rectal cancer combined with transverse colon/terminal ileostomy.The method of random digital table was divided into observation group and control group,each group was 60 cases.The patients in the observation group were given Yiqi Tongfu Decoction at the same time.The recovery indexes,nutrition indexes,immune indexes and complications were compared in the two groups.Results:Compared with the control group,the postoperative rehabilitation index levels of the observation group were decreased,the nutritional indexes and immunoglobulin A(IGA),IgG,IgM,CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)levels of the observation group were increased on the 7 th day after operation,and the CD_(8)^(+)levels were decreased,the difference was statistically significant(P<0.05).Compared with the control group,the incidence of nausea and vomiting,parastomal hernia,wound infection,anastomotic leakage and anastomotic stenosis in the observation group was lower,and the difference was statistically significant(P<0.05).Conclusion:Protective enterostomy combined with Yiqi Tongfu decoction can effectively improve the nutritional status of rectal cancer patients undergoing laparoscopic surgery,enhance immunity,promote postoperative recovery,and reduce the incidence of complications.

关 键 词：直肠癌 益气通腑汤 腹腔镜低位直肠癌前切除术 保护性肠造口术 营养状况 

分 类 号：R259.571[医药卫生—中西医结合]