小承气汤加减灌肠方联合电针治疗晚期恶性不全性肠梗阻患者的疗效观察  

Therapeutic Effect of Xiaochengqi Decoction Combined with Modified Enema and Electroacupuncture in the Treatment of Advanced Malignant Incomplete Intestinal Obstruction

作　　者：张明霞 朱建平 王建霞 李亚欣 梁超 ZHANG Ming-xia;ZHU Jian-ping;WANG Jian-xia;LI Ya-xin;LIANG Chao(Department of Geriatrics,Beijing First Hospital of Integrated Chinese and Western Medicine,Beijing 100018;Department of Oncology,Beijing First Hospital of Integrated Chinese and Western Medicine,Beijing 100018;Department of Oncology,Beijing Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 100089)

机构地区：[1]北京市第一中西医结合医院老年病科,北京100018 [2]北京市第一中西医结合医院肿瘤科,北京100018 [3]北京市中西医结合医院肿瘤科,北京100089

出　　处：《世界中西医结合杂志》2024年第4期750-754,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：首都卫生发展科研专项项目(首发2018-3-7042)。

摘　　要：目的 探讨小承气汤加减灌肠方联合电针治疗晚期恶性不全性肠梗阻患者的临床疗效。方法 选取2019年1月—2021年12月期间北京市第一中西医结合医院收治的128例晚期恶性不全性肠梗阻患者,按随机数字表法分成对照组和观察组,每组64例。对照组给予常规西医治疗+小承气汤加减灌肠方治疗,观察组在对照组治疗基础上联合电针治疗,两组患者均连续治疗7 d。观察比较两组患者治疗前后梗阻症状评分(恶心呕吐、腹胀、腹痛、排便情况)、KPS(Karnofsky)评分、腹部X线梗阻阳性率情况,并比较两组患者总有效率和治疗方案的安全性。结果 治疗后两组患者各项梗阻症状评分均较治疗前降低,差异有统计学意义(P<0.05),且观察组各项梗阻症状评分均明显低于对照组,差异有统计学意义(P<0.05);治疗后两组KPS评分均较治疗前升高,差异有统计学意义(P<0.05),且观察组KPS评分均明显高于对照组,差异有统计学意义(P<0.05);治疗后观察组腹部X线梗阻阳性率为12.5%(8/64),明显低于对照组的45.3%(29/64),差异有统计学意义(P<0.05);治疗后观察组临床总有效率为84.4%(54/64),明显高于对照组的65.6%(42/64),差异有统计学意义(P<0.05)。治疗期间,两组患者血压、脉搏、心率、呼吸等生命体征指标,肾功能、肝功能,血常规、尿常规、粪常规及心电图均未发生异常。结论 小承气汤加减灌肠方联合电针治疗晚期恶性不全性肠梗阻疗效显著,能够快速缓解患者临床症状,改善腹部X线梗阻情况,提高患者生活质量,且无明显不良反应,安全且有效。Objective To investigated the effectiveness of Xiaochengqi Decoction combined with modified enema and electroacupuncture in treating patients with advanced malignant incomplete intestinal obstruction.Methods A total of 128 patients with this condition admitted to the Beijing First Hospital of Integrated Chinese and Western Medicine from January 2019 to December 2021 were selected and assigned to a control group and an observation group by random number table,with 64 in each group.The control group received standard Western treatment+Xiaochengqi Decoction combined with modified enema,while the observation group was given additional electroacupuncture on the basis of the control group.Both groups were treated continuously for 7 days.Changes in obstructive symptom scores(nausea,vomiting,bloating,abdominal pain,bowel movements),Karnofsky Performance Status(KPS)scores,and the positive rate of obstruction on abdominal X-rays were compared between the groups,alongside the overall efficacy and the safety of the treatment plans.Results After treatment,obstructive symptom scores in both groups decreased compared with the conditions before treatment(P<0.05),with the observation group scoring lower than the control group(P<0.05).KPS scores were improved after treatment in both groups(P<0.05),and the scores were higher in the observation group(P<0.05).The positive rate of obstruction on abdominal X-rays in the observation group was 12.5%(8/64),lower than the 45.3%(29/64)in the control group(P<0.05).Additionally,the total clinical effective rate of the observation group was 84.4%(54/64),higher than the 65.6%(42/64)in the control group(P<0.05).Vital signs and functions,including blood pressure,pulse,heart rate,respiration,kidney and liver function,and routine blood,urine,and stool tests,as well as electrocardiograms,showed no abnormalities in the two groups during treatment.Conclusion Xiaochengqi Decoction combined with modified enema and electroacupuncture provides substantial benefits in the management of advanced malignant i

关 键 词：晚期恶性不全性肠梗阻 小承气汤加减方 中药灌肠 电针 腹部X线 KPS评分 

分 类 号：R245.97[医药卫生—针灸推拿学] R574[医药卫生—中医临床基础]