大承气汤保留灌肠与热奄包烫熨联合常规疗法治疗胃大部切除术后肠梗阻临床研究  

Clinical Study on Retention Enema with Dachengqi Tang and Hot Package Ironing Combined with Routine Therapy for Intestinal Obstruction After Subtotal Gastrectomy

作　　者：吴玲利 杨利娜 裴嫣嫣 WU Lingli;YANG Lina;PEI Yanyan

机构地区：[1]中国人民解放军联勤保障部队第九八八医院普外科,河南焦作454000

出　　处：《新中医》2021年第22期1-5,共5页New Chinese Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200791)。

摘　　要：目的:观察在常规疗法基础上加用大承气汤加减保留灌肠联合热奄包烫熨治疗胃大部切除术后肠梗阻的疗效。方法:纳入100例胃大部切除术后肠梗阻患者作为观察对象,根据治疗方式不同分为对照组、观察组各50例。2组均予常规疗法治疗,观察组加予大承气汤加减保留灌肠联合热奄包烫熨干预,2组均治疗2周。比较2组的临床疗效以及腹胀腹痛缓解时间、排便恢复时间、排气恢复时间、恶心呕吐缓解时间。治疗前与治疗2周后评定中医证候积分,检测血清炎症因子[白细胞介素-6(IL-6)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平。结果:治疗2周后,观察组临床疗效总有效率为90.0%,高于对照组的76.0%,差异有统计学意义(P<0.05)。2组中医证候积分均较治疗前下降(P<0.05),观察组中医证候积分低于对照组(P<0.05)。观察组腹胀腹痛缓解时间、排便恢复时间、排气恢复时间、恶心呕吐缓解时间均较对照组缩短(P<0.05)。2组TNF-α、IL-6、CRP水平均较治疗前降低(P<0.05),观察组3项指标值均低于对照组(P<0.05)。结论:在常规疗法基础上加用大承气汤加减保留灌肠联合热奄包烫熨治疗胃大部切除术后肠梗阻患者临床疗效好,可加快症状缓解,促进术后肠道功能恢复,其作用机制可能与调节患者的炎性因子水平有关。Objectives:To observe the curative effect of retention enema with modified Dachengqi tang combined with hot package ironing for intestinal obstruction after subtotal gastrectomy based on the routine therapy.Methods:A total of100 cases of patients with intestinal obstruction after subtotal gastrectomy were selected as the observational subjects and divided into the control group and the observation group according to different treatment methods,with 50 cases in each group.Both groups were treated with routine therapy,and the observation group was additionally intervened with retention enema with modified Dachengqi tang combined with hot package ironing.Both groups were treated for two weeks.The clinical effects,the relief time of abdominal distension and pain as well as nausea and vomiting,and the recovery time of defecation as well as exhaust in the two groups were compared.Before treatment and after two weeks of treatment,the Chinese medicine syndrome scores were evaluated,and the levels of serum inflammatory factors including interleukin-6(IL-6),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)were detected.Results:After two weeks of treatment,the total effective rate was 90.0%in the observation group,higher than of 76.0%in the control group,the difference being significant(P<0.05).The Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the Chinese medicine syndrome score in the observation group was lower than that in the control group(P<0.05).The relief time of abdominal distension and pain as well as nausea and vomiting,and the recovery time of defecation as well as exhaust in the observation group were shortened when compared with those in the control group(P<0.05).The levels of TNF-α,IL-6 and CRP in the two groups were decreased when compared with those before treatment(P<0.05),and the three indexes in the observation group were lower than those in the control group(P<0.05).Conclusion:Based on routine therapy,retention enema wit

关 键 词：肠梗阻 阳明腑实证 大承气汤 保留灌肠 热奄包 烫熨 炎症因子 

分 类 号：R735.2[医药卫生—肿瘤]