厚朴排气汤治疗术后早期炎性肠梗阻临床研究  

Clinical Study on Houpo Paiqi Decoction for Early Postoperative Inflammatory Ileus

作　　者：郑迪锋 王焕根 ZHENG Difeng;WANG Huangen

机构地区：[1]绍兴市中心医院医共体总院胃肠外科,浙江绍兴312030

出　　处：《新中医》2023年第1期84-88,共5页New Chinese Medicine

摘　　要：目的:观察厚朴排气汤治疗术后早期炎性肠梗阻的临床疗效及安全性。方法:选择100例腹部手术后早期炎性肠梗阻患者,根据治疗方式不同分为对照组与观察组各50例,对照组予常规奥曲肽治疗,观察组在常规治疗基础上加用厚朴排气汤内服。比较2组临床疗效,肠道功能恢复情况,胃管留置、进食、体温恢复、白细胞恢复、住院时间,不良反应发生情况及治疗前后血管活性肠肽(VIP)、降钙素原(PCT)、一氧化氮(NO)、炎症因子水平。结果:观察组治疗总有效率92.00%,高于对照组80.00%(P<0.05)。观察组腹痛减轻、腹胀缓解、肠鸣音恢复、首次通气及首次排便时间均短于对照组(P<0.05)。观察组胃管留置、进食、体温恢复、白细胞恢复时间及住院时间均短于对照组(P<0.05)。治疗前,2组血清单核细胞趋化蛋白-1 (MCP-1)、白细胞介素-6 (IL-6)、白细胞介素-8 (IL-8)、肿瘤坏死因子-α (TNF-α)水平比较,差异无统计学意义(P>0.05);治疗后,2组血清MCP-1、IL-6、IL-8、TNF-α水平均下降(P<0.05),且观察组低于对照组(P<0.05)。治疗前,2组血清VIP、PCT、NO水平比较,差异无统计学意义(P>0.05);治疗后,2组血清VIP、PCT、NO水平均下降(P<0.05),且观察组低于对照组(P<0.05)。观察组不良反应发生率6.00%,低于对照组12.00%(P<0.05)。结论:厚朴排气汤提高了术后早期炎性肠梗阻患者的临床疗效,可解除肠梗阻,缩短病程,调节神经介质,降低炎症因子水平,不良反应少,安全性高。Objective: To observe the clinical effect of Houpo Paiqi Decoction on early postoperative inflammatory ileus and its safety. Methods: A total of 100 patients with early inflammatory ileus after abdominal surgery were selected and divided into the control group and the observation group according to different treatment methods,with 50 cases in each group. The control group was treated with conventional Octreotide,and the observation group was additionally treated with Houpo Paiqi Decoction based on the conventional treatment. The clinical effects,intestinal function recovery,the time of gastric tube indwelling,feeding,body temperature recovery,white blood cell recovery and length of hospital stay,incidence of adverse reactions,and levels of vasoactive intestinal peptide(VIP),procalcitonin(PCT),nitric oxide(NO) and inflammatory factors before and after treatment were compared between the two groups. Results: The total effective rate was 92.00% in the observation group,higher than that of 80.00% in the control group(P<0.05). The time of abdominal pain relief, abdominal distension relief, bowel sound recovery, first ventilation and first defecation time in the observation group was respectively shorter than that in the control group(P<0.05). The time of gastric tube indwelling,feeding,body temperature recovery,white blood cell recovery and length of hospital stay in the observation group was respectively shorter than that in the control group(P<0.05). Before treatment, there was no significant difference in serum levels of monocyte chemoattractant protein-1(MCP-1),interleukin-6(IL-6),interleukin-8(IL-8) and tumor necrosis factor-α(TNF-α) between the two groups(P>0.05);after treatment,the serum levels of MCP-1,IL-6,IL-8 and TNF-α in the two groups were decreased(P<0.05),and those in the observation group were lower than those in the control group(P<0.05). Before treatment,there was no significant difference in serum VIP,PCT and NO levels between the two groups(P>0.05);after treatment,the serum levels of VIP,PCT and

关 键 词：术后早期炎性肠梗阻 厚朴排气汤 炎症因子 肠道功能 血管活性肠肽 降钙素原 

分 类 号：R656.7[医药卫生—外科学]