大承气汤加减对腹部手术术后早期炎症性肠梗阻患者胃肠功能恢复及预后的影响  

Effect of Modified Dachengqi Decoction(大承气汤加减)on Gastrointestinal Function Recovery and Prognosis in Patients with Early Inflammatory Intestinal Obstruction after Abdominal Surgery

作　　者：丁孟德 冯丹丹 DING Mengde(FENG Dandan,Yongkang First People's Hospital,Yongkang 321300,Zhejiang,China)

机构地区：[1]永康市第一人民医院,浙江永康321300

出　　处：《辽宁中医杂志》2023年第3期85-88,共4页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的 探讨大承气汤加减对腹部手术术后早期炎症性肠梗阻(EPISBO)患者胃肠功能恢复及预后的影响。方法 纳入2017年1月—2021年6月永康市第一人民医院收治的腹部手术术后EPISBO患者64例,用随机数表法分观察组(32例)和对照组(32例)。对照组用奥曲肽治疗,观察组在对照组基础上加用大承气汤加减治疗。治疗2个疗程后比较疗效及胃肠功能恢复情况,记录治疗前后C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)变化,统计两组不良反应及复发率。结果 观察组总有效率为96.88%(31/32),明显高于对照组78.13%(25/32),差异有统计学意义(P<0.05);观察组的肠鸣音恢复时间、肛门排气时间、排便时间、腹部症状消失时间、胃管撤离时间均分别短于对照组,差异有统计学意义(P<0.05);治疗后,两组的炎症因子水平均低于治疗前,且观察组的CRP、TNF-α、IL-6、PCT明显低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05),观察组复发率为3.13%(2/32),明显低于对照组的21.88%(7/32),差异有统计学意义(P<0.05)。结论 大承气汤加减可促进EPISBO患者胃肠功能恢复,减轻术后体内炎症,复发率低,安全性高,效果理想,可在临床推广运用。Objective To investigate the effect of Modified Dachengqi Decoction((大承气汤加减)on the recovery of gastrointestinal function and prognosis in patients with early inflammatory intestinal obstruction(EPISBO)after abdominal surgery.Methods Sixty-four patients with EPISBO after abdominal surgery in the hospital from January 2017 to June 2021 were selected as the research objects.They were randomly divided into two groups with 32 cases in each group.The control group was treated with octreotide injection,and the observation group was treated with Modified Dachengqi Decoction on the basis of the control group.After two courses of treatment,the curative effect and recovery of gastrointestinal function were compared,and the changes of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)and procalcitonin(PCT)were recorded before and after treatment and the adverse reactions and recurrence rates of the two groups were counted.Results The total effective rate in the observation group was 96.88%(31/32),which was significantly higher than 78.13%(25/32)in the control group(P<0.05).The recovery time of bowel sounds,anal exhaust time,defecation time and disappearance time of abdominal symptoms and evacuation time of gastric tube in the observation group were significantly shorter than those in the control group(P<0.05).After treatment,the levels of inflammatory factors in the two groups were lower than those before treatment,and the levels of CRP and TNF-αin the observation group were lower than those before treatment and the levels of IL-6 and PCT were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The recurrence rate in the observation group was 3.13%(2/32),which was significantly lower than 21.88%(7/32)in the control group(P<0.05).Conclusion Dachengqi Decoction can promote the recovery of gastrointestinal function and reduce postoperative inflammation in patients with EPISBO

关 键 词：炎症性肠梗阻 腹部手术 胃肠功能 大承气汤 炎症因子 疗效 不良反应 复发率 

分 类 号：R574.2[医药卫生—消化系统]