补中益气加味汤应用于老年疝病患者不同疝修补术后的临床疗效分析  

An analysis of clinical efficacy of the Buzhong Yiqi decoction on herniosis in senile patients after hernia repair

作　　者：任笠坤 杨陈陈 杨芳 刘运权 陆进 艾飞 高波 周世勇 REN Likun

机构地区：[1]贵州中医药大学第二附属医院,贵州贵阳550000

出　　处：《中医临床研究》2023年第28期62-68,共7页Clinical Journal Of Chinese Medicine

基　　金：贵州中医药大学第二附属医院重点优势病种中医临床疗效评价项目(GZEYK-Y[2021]7)。

摘　　要：目的:探究补中益气加味汤对老年疝病患者行不同疝修补术后恢复情况和临床应用价值。方法:筛选2019年1月-2022年1月间贵州中医药大学第二附属医院诊治的老年疝病患者的临床资料,经不同疝修补术后加用补中益气加味汤,评价分析补中益气加味汤在老年疝病患者疝修补术后的临床疗效。结果:200例老年腹股沟疝患者,分为A组[予李金斯坦术(Lichtenstein)]、B组[予经腹膜前补片植入术(Transabdominal Preperitoneal Prosthesis,TAPP)]及C组[予完全经腹膜外补片修补术(Totally Extraperitoneal Prosthetic,TEP)]。A组69例,分为研究组39例,对照组30例;B组95例,分为研究组49例,对照组46例;C组36例,分为研究组25例,对照组11例。三组组内比较研究显示,与对照组比较,研究组血清中性粒细胞百分比及C反应蛋白明显下降(P<0.05);研究组肛门排气时间恢复更快(P<0.05)。此外,与对照组比较,A、B两组中研究组的术后伤口恢复情况更好(P<0.05);C组患者伤口恢复情况对比无明显差异(P>0.05)。A、B两组中,研究组术后并发症(阴囊气肿、尿潴留、血清肿)发生例数更少(P<0.05);C组患者并发症对比无明显差异(P>0.05)。术后所有患者均随访1~3年,中位随访时间为1.35(1.05,1.65)年。研究组和对照组36项简明健康状况调查量表评分的差异均无统计学意义(P>0.05),总体恢复良好。结论:不同疝修补术后应用补中益气加味汤,可早期恢复患者胃肠道功能、减少伤口感染率、减少术后并发症的发生,值得临床推广。Objective:To explore the clinical application value of the Buzhong Yiqi Jiawei decoction(补中益气加味汤)for elderly patients with hernia after different hernioplasty and the recovery of patients.Methods:The clinical data of elderly patients with hernia treated in the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2019 to January 2022 was screened,the Buzhong Yiqi Jiawei decoction was given additionaly after different herniorrhaphy,and the clinical efficacyO of the Buzhong Yiqi Jiawei decoction after herniorrhaphy in elderly patients was evaluated and analyzed.Results:There were 200 elderly patients with inguinal hernia,which were divided into group A:Lichtenstein group,group B:Transabdominal Preperitoneal Prosthesis(TAPP)group,and group C:Total Extraperitoneal Prosthesis(TEP)group.There were 69 cases in group A(39 cases in study group and 30 cases in control group),95 cases in group B(49 cases in the study group and 46 cases in the control group),and 36 cases in group C(25 cases in the study group and 11 cases in the control group).Compared with the control group,the percentage of serum neutrophils and C-reactive protein in the study group were decreased significantly(P<0.05).The anal exhaust recovered time in the study group was shorter(P<0.05).In addition,compared with the control group,the wound recovery in the study group in group A and B was better(P<0.05).There was no significant difference in wound recovery within group C(P>0.05).In group A and group B,there were fewer cases of postoperative complications(scrotal emphysema,urinary retention,and seroma)in the study group(P<0.05).There was no significant difference in the complications within group C(P>0.05).All patients were followed up for 1-3 years,with a median follow-edup of 1.35(1.05,1.65)years.There was no significant difference in the SF-36 score between the study group and the control group(P>0.05),and the overall recovery was good.Conclusion:The application of the Buzhong Yiqi Jiawei decoction a

关 键 词：老年腹股沟疝 疝修补术 补中益气加味汤 临床疗效 

分 类 号：R256.45[医药卫生—中医内科学]