自拟排气汤加减对剖宫产术后产妇胃肠激素及胃肠功能的影响  

Effect of modified self-made exhaust decoction on gastrointestinal hormones and gastrointestinal function in puerperants after cesarean section

作　　者：陈俊杰 周艳艳[1] 李岩 许雪梅[1] CHEN Jun-jie;ZHOU Yan-yan;LI Yan;XU Xue-mei(Department of Obstetrics and Gynecology,Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450002,Henan,CHINA)

机构地区：[1]河南省中医院妇产科,河南郑州450002

出　　处：《海南医学》2024年第11期1581-1584,共4页Hainan Medical Journal

基　　金：河南省中医药科学研究专项课题(编号:2021JDZX2107)。

摘　　要：目的探讨自拟排气汤加减对剖宫产术后产妇胃肠激素及胃肠功能的影响。方法选择2020年1月至2023年1月在河南省中医院行剖宫产术的150例产妇作为研究对象,按随机数表法分为观察组和对照组各75例。对照组产妇给予常规西医治疗,观察组产妇在对照组基础上加用自拟排气汤加减治疗,治疗3 d。比较两组产妇的胃肠功能恢复情况和治疗前后的中医证候积分(胃脘疼痛、脘腹胀痛、嗳气反酸、舌淡脉虚)、胃肠激素指标[血清胃泌素(GAS)、血管活性肠肽(VIP)、胃动素(MTL)]变化,比较两组产妇治疗期间的不良反应发生情况。结果观察组产妇的肠鸣音恢复、首次排气、首次排便、首次进食固体食物时间分别为(14.98±2.10)h、(15.82±3.01)h、(28.41±5.04)h、(51.29±6.23)h,明显短于对照组的(18.26±2.56)h、(19.34±2.94)h、(33.18±4.87)h、(66.82±5.89)h,差异均有统计学意义(P<0.05);治疗前两组产妇的胃脘疼痛、脘腹胀痛、嗳气反酸、舌淡脉虚评分比较差异均无统计学意义(P>0.05),治疗后,两组产妇的胃脘疼痛、脘腹胀痛、嗳气反酸、舌淡脉虚评分均明显降低,且观察组分别为(3.28±0.43)分、(3.01±0.62)分、(2.98±0.62)分、(3.01±0.73)分,明显低于对照组的(4.62±0.51)分、(4.30±0.78)分、(3.72±0.71)分、(3.98±0.82)分,差异均有统计学意义(P<0.05);治疗前,两组产妇的GAS、MTL、VIP比较差异均无统计学意义(P>0.05),治疗后,两组产妇的GAS、MTL明显升高,且观察组的GAS、MTL分别为(122.81±10.48)pg/mL、(352.29±20.17)ng/L,明显高于对照组的(102.39±9.45)pg/mL、(321.29±19.45)ng/L,而VIP明显降低,且观察组的VIP为(18.20±2.09)pg/mL,明显低于对照组的(20.18±1.94)pg/mL,差异均有统计学意义(P<0.05);观察组产妇的不良反应总发生率为6.67%,略低于对照组的9.33%,但差异无统计学意义(P>0.05)。结论自拟排气汤加减可有效调节剖宫产术后产妇的胃肠激素水平,缓解�Objective To explore the effects of modified self-made exhaust decoction on gastrointestinal hormones and gastrointestinal function in puerperants after cesarean section.Methods A total of 150 postpartum women who underwent cesarean section in Henan Provincial Hospital of Traditional Chinese Medicine from January 2020 to January 2023 were selected as the research subjects,whch were divided into an observation group and a control group using a random number table method,with 75 cases in each group.Patients in the control group were treated with conventional Western medicine,while those in the observation group were treated with modified self-made exhaust decoction on this basis,for 3 days.The recovery of gastrointestinal function in two groups of patients was compared,as well as the traditional Chinese medicine syndrome scores(epigastric pain,epigastric distension,belching and acid reflux,tongue weakness and pulse deficiency),changes in gastrointestinal hormone indicators[serum gastrin(GAS),vasoactive intestinal peptide(VIP),and motilin(MTL)],and adverse reactions during the treatment period.Results The recovery time of bowel sounds,first exhaust,first defecation,and first consumption of solid food in the observation group were(14.98±2.10)h,(15.82±3.01)h,(28.41±5.04)h,(51.29±6.23)h,which were significantly shorter than(18.26±2.56)h,(19.34±2.94)h,(33.18±4.87)h,(66.82±5.89)h in the control group(P<0.05).There was no statistically significant difference in the scores of epigastric pain,epigastric distension,belching and acid reflux,and tongue weakness and pulse deficiency between the two groups of patients before treatment(P>0.05).After treatment,the scores of epigastric pain,epigastric distension,belching and acid reflux,and tongue weakness and pulse deficiency in both groups were significantly reduced,and the scores in the observation group were(3.28±0.43)points,(3.01±0.62)points,(2.98±0.62)points,and(3.01±0.73)points,which were significantly lower than(4.62±0.51)points,(4.30±0.78)points,(3.72±0.71)p

关 键 词：剖宫产 自拟排气汤 胃肠激素 胃肠功能 中医证候 不良反应 

分 类 号：R719.8[医药卫生—妇产科学]