浓煎大承气汤在老年癌性不全肠梗阻中的应用  

Application of Concentrated Dachengqi Tang in Senile Patients with Cancer-Related Incomplete Intestinal Obstruction

作　　者：郑香琴 冯惠春 郑晓真[1] 沈苏珍 吴娟萍 丁纪元[1] ZHENG Xiangqin;FENG Huichun;ZHENG Xiaozhen;SHEN Suzhen;WU Juanping;DING Jiyuan

机构地区：[1]杭州市肿瘤医院,浙江杭州310002

出　　处：《新中医》2021年第9期102-106,共5页New Chinese Medicine

基　　金：杭州市卫生计生科技计划项目(2017A34)。

摘　　要：目的:观察浓煎大承气汤在老年癌性不全肠梗阻中的应用效果。方法:将80例老年癌性不全肠梗阻患者按随机数字表法分为对照组和观察组各40例。对照组在常规治疗基础上给予常规煎剂大承气汤200 mL保留灌肠,观察组在常规治疗基础上给予浓煎大承气汤50 mL保留灌肠,每天2次,连续治疗2周。比较2组临床疗效及主要症状的改善时间、药物保留时间,观察腹部X线平片肠管气液平面、肠腔积气的变化,测定血清中降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)等炎症因子水平。结果:观察组总有效率为97.50%,对照组为87.50%,2组比较,差异无统计学意义(P>0.05)。治疗后观察组肛门排气时间、排便时间、腹痛消失时间、腹胀消失时间、肠鸣音恢复时间与对照组相比均明显缩短,药物保留时间明显延长(P<0.05)。治疗后观察组腹部X线平片改善优于对照组,其肠管气液平面消失、肠腔积气减少数均明显多于对照组(P<0.05)。治疗前,2组PCT、TNF-α、IL-8水平比较,差异无统计学意义(P>0.05)。治疗后,2组PCT、TNF-α、IL-8水平较治疗前降低,且观察组PCT、TNF-α、IL-8水平均低于对照组,差异均有统计学意义(P<0.05)。结论:浓煎大承气汤治疗老年癌性不全肠梗阻具有更好的临床效果,更利于改善患者的临床症状,延长药物保留时间,促进胃肠功能的恢复,减轻机体炎症反应。Objective:To observe the application effect of concentrated Dachengqi tang in senile patients with cancerrelated incomplete intestinal obstruction.Methods:A total of 80 cases of senile patients with cancer-related incomplete intestinal obstruction were divided into the control group and the observation group according to the random number table method,40 cases in each group.Based on routine treatment,the control group was additionally given retention enema with200 mL of Dachengqi tang,and the observation group was additionally given retention enema with 50 mL of Dachengqi tang,twice a day for 2 weeks.The clinical effect,the improvement time of main symptoms and the drug retention time in the two groups were compared;the changes in gas-liquid plane of intestinal tube and intestinal pneumatosis in abdominal X-ray plain film were observed;the levels of inflammatory factors including procalcitonin(PCT),tumor necrosis factor-α(TNF-α)and interleukin-8(IL-8)in serum were measured.Results:The total effective rate was 97.50% in the observation group and 87.50% in the control group,there being no significance in the difference(P>0.05).After treatment,the anal exhaust time,the defecation time,the disappearance time of abdominal pain and abdominal distention and the recovery time of bowel sounds in the observation group were significantly shortened when compared with those in the control group,and the drug retention time was significantly prolonged(P<0.05).After treatment,the improvement of abdominal X-ray plain film in the observation group was better than that in the control group,and the disappearance of gas-liquid plane of intestinal tube and the reduction of intestinal pneumatosis were significantly more(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of PCT,TNF-α and IL-8 between the two groups(P>0.05).After treatment,the levels of PCT,TNF-α and IL-8 in the two groups were decreased when compared with those before treatment,and the above levels in the observation

关 键 词：不全性肠梗阻 肠癌 大承气汤 浓煎 胃肠功能 腹部X线平片 炎症因子 

分 类 号：R574.2[医药卫生—消化系统] R735.3[医药卫生—内科学]