扶正理气中药汤改良保留灌肠联合西药穴位注射治疗急性胰腺炎合并麻痹性肠梗阻疗效及对胃泌素、胃动素、血管活性肠肽的影响  

Efficacy of Fuzheng Liqi Decoction and Modified Retention Enema Combined with Western Medicine Point Injection on Acute Pancreatitis Complicated with Paralytic Intestinal Obstruction and Its Influence on GAS,MTL and VIP

作　　者：秦倩仪 范小华[1,2] QIN Qian-yi;FAN Xiao-hua(Guangzhou University of Traditional Chinese Medicine,Guangzhou Guangdong 510030;Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou Guangdong 510030)

机构地区：[1]广州中医药大学,广东广州510030 [2]广东省中医院,广东广州510030

出　　处：《世界中西医结合杂志》2022年第1期99-104,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：广东省中医药局科研项目(20201148)。

摘　　要：目的观察扶正理气中药汤改良保留灌肠联合西药穴位注射治疗急性胰腺炎(Acute pancreatitis,AP)合并麻痹性肠梗阻(Paralytic ileus,PI)疗效及对胃泌素(Gastrin,GAS)、胃动素(Motilin,MTL)、血管活性肠肽(Vasoactive intestinal peptide,VIP)的影响。方法选取2017年1月—2018年12月期间于广东省中医院就诊的AP合并PI患者114作为研究对象,按照随机数字表法分为两组,每组各57例。对照组给予常规的西药对症治疗;观察组则给予扶正理气中药汤改良保留灌肠联合西药穴位注射治疗,两组患者均治疗7 d。观察比较两组患者临床症状改善情况、临床结局、口盲传递时间(Oro-cecal transit time,OCTT)和腹内压水平、MTL、GAS、VIP以及5-羟色胺(5-hydroxytryptamine,5-HT)、炎症相关指标和淋巴细胞亚群水平。结果观察组患者治疗后腹痛缓解时间、腹胀缓解时间、首次排气时间、肠鸣音恢复时间、首次排便时间、禁食时间均较对照组缩短,胃肠减压引流量较对照组降低,差异有统计学意义(P<0.05)。临床结局观察组患者较对照组住院时间减少,住院费用降低,并发症发生率降低,差异有统计学意义(P<0.05)。两组患者治疗后APACHEⅡ评分较治疗前降低,差异有统计学意义(P<0.05);观察组患者治疗3 d、7 d后APACHEⅡ评分均较对照组降低,差异有统计学意义(P<0.05)。两组患者治疗后OCTT和腹内压均较治疗前降低,差异有统计学意义(P<0.05);且观察组患者治疗3 d、7 d后OCTT和腹内压均较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗后血清VIP、5-HT、MTL和GAS水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组患者治疗3 d、7 d后血清VIP、5-HT、MTL和GAS水平均较对照组明显升高,差异有统计学意义(P<0.05)。两组患者治疗后血清hs-CRP、TNF-α和IL-8水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组患者治疗3 d、7 d后血清hs-CRP、TNFObjective To observe the efficacy of Fuzheng Liqi decoction with modified retention enema combined with western medicine point injection on acute pancreatitis(AP)complicated with paralytic ileus(PI)and its influence on gastrin(GAS),gastric motility Motilin(MTL),vasoactive intestinal peptide(VIP).Methods A total of 114 patients withAP and PI who were treated in Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2017 to December 2018 were selected as the research subjects,and divided into two groups according to the random number rule,with 57 cases in each group.The control group was given conventional western medicine symptomatic treatment;the observation group was given Fuzheng Liqi Traditional Chinese Medicine Decoction modified retention enema combined with western medicine acupoint injection,both groups were treated for 7 days.Then the clinical symptom improvement,clinical outcome,oral blind transmission time(OCTT)and intra-abdominal pressure level,MTL,GAS,VIP,5-hydroxytryptamine(5-HT),inflammation related indicators and lymphocyte subpopulation level were compared between the two groups.Results After treatment,the abdominal pain relief time,abdominal distension relief time,first flatus time,bowel sound recovery time,first defecation time and fasting time in the observation group were all shorter than those in the control group,and the gastrointestinal decompression and drainage volume was lower than that in the control group.The difference was statistically significant(P<0.05).Compared with the control group,the patients in the observation group had shorter hospitalization time,lower hospitalization costs,and lower incidence of complications,and the differences were statistically significant(P<0.05).After treatment,the APACHE II scores of the two groups of patients were lower than those before treatment,and the difference was statistically significant(P<0.05).The OCTT and intra-abdominal pressure of the two groups of patients after treatment were lower than those before treatment,and t

关 键 词：扶正理气中药汤 改良保留灌肠 急性胰腺炎 麻痹性肠梗阻 

分 类 号：R657.51[医药卫生—外科学] R574.2[医药卫生—临床医学]