六磨汤联合芒硝外敷对术后早期炎性肠梗阻患者肠道屏障功能及血清血管活性肠肽水平的影响  

Effects of Liumo decoction combined with mirabilite external application on intestinal barrier function and serum VIP level in patients with early postoperative inflammatory small bowel obstruction

作　　者：石鹏[1] 王翠敏 张宏昭 SHI Peng;WANG Cui-min;ZHANG Hong-zhao(Department of Surgery,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei(050051),China)

机构地区：[1]石家庄市中医院外科,石家庄050051 [2]石家庄市中医院脉管科,石家庄050051

出　　处：《中国中西医结合外科杂志》2024年第4期476-480,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2020344)。

摘　　要：目的:探讨六磨汤联合芒硝外敷对术后早期炎性肠梗阻(EPISBO)患者肠道屏障功能及血清血管活性肠肽(VIP)水平的影响。方法:选取2021年11月—2022年11月我院收治的符合标准的98例EPISBO患者,采用随机数字表法分为对照组(n=49)及研究组(n=49)。对照组进行常规治疗,研究组在对照组的基础上给予六磨汤联合芒硝外敷治疗。比较两组临床疗效、治疗前后胃肠功能恢复时间、胃肠激素水平、血清炎症因子水平和不良反应发生率。结果:研究组总有效率高于对照组(91.84%vs 75.51%,P<0.05)。研究组腹部症状缓解时间、肠鸣音恢复时间以及肛门排气时间均低于对照组(6.37±0.97 vs 8.56±1.29,5.31±0.76 vs 7.16±0.93,6.37±1.09 vs 8.16±1.16,P<0.05)。治疗前,两组的血清VIP、胃动素(MOT)、胃泌素(GAS)水平无统计学差异(31.76±5.87 vs 31.08±5.63,187.29±26.39 vs 186.32±25.97,108.67±21.76 vs 111.62±26.89,P>0.05),治疗后,两组的血清VIP水平都有所降低,MOT、GAS水平都有所升高,相对而言,研究组的血清VIP水平降低更多,MOT、GAS水平升高更多(16.23±3.66 vs 20.75±4.37,289.67±38.52 vs 231.56±31.26,179.65±39.55 vs 142.34±31.76,P<0.05)。治疗前,两组的血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平无差异(65.19±7.83 vs 63.13±7.56,67.59±9.27 vs 67.11±8.96,59.13±8.52 vs 58.77±8.78,P>0.05),治疗后,两组的血清TNF-α、CRP、IL-6水平都有所降低,且研究组的血清TNF-α、CRP、IL-6水平降低更多(19.37±3.65 vs 29.82±5.23,17.26±3.25 vs 27.51±4.16,15.56±2.44 vs 23.41±3.53,P<0.05)。结论:六磨汤联合芒硝外敷可有效改善EPISBO患者的临床症状,降低胃肠功能恢复的时间,调节胃肠激素水平和血清炎症因子,且具有一定的安全性。Objective To explore the effects of Liumo decoction combined with mirabilite external application on intestinal barrier function and serum vasoactive intestinal peptide(VIP)level in patients with early postoperative inflammatory small bowel obstruction(EPISBO).Methods The study population was selected from 98 EPISBO patients who met the criteria and were admitted to our hospital from November 2021 to November 2022,and were equally divided into two groups:control group(n=49)and study group(n=49).The reference group received routine treatment on the basis of routine care,while the research group received Liumo decoction combined with mirabilite external application treatment on the basis of the reference group.The clinical efficacy,recovery time of gastrointestinal function,levels of gastrointestinal hormones,serum inflammatory factor levels before and after treatment,and untoward reactions of the two groups were compared.Results After treatment,the total effective rate of the test group was higher than that of the reference group(91.84%vs 75.51%,P<0.05).Compared with the reference group,the abdominal symptom relief time,bowel sound recovery time,and anal exhaust time in test group decreased(6.37±0.97 vs 8.56±1.29,5.31±0.76 vs 7.16±0.93,6.37±1.09 vs 8.16±1.16,P<0.05).Before treatment,there was no difference in serum VIP,MOT,and GAS levels between the two groups(31.76±5.87 vs 31.08±5.63,187.29±26.39 vs 186.32±25.97,108.67±21.76 vs 111.62±26.89,P>0.05),and after treatment,serum VIP levels decreased and MOT and GAS levels increased in both groups,and relatively speaking,serum VIP levels decreased more and MOT and GAS levels increased more in the study group(16.23±3.66 vs 20.75±4.37,289.67±38.52 vs 231.56±31.26,179.65±39.55 vs 142.34±31.76,P<0.05).Before treatment,the serum TNF-α,CRP,and IL-6 levels of the two groups did not differ(65.19±7.83 vs 63.13±7.56,67.59±9.27 vs 67.11±8.96,59.13±8.52 vs 58.77±8.78,P>0.05),after treatment,the serum TNF-α,CRP,and IL-6 levels of the two groups were reduce

关 键 词：六磨汤 芒硝外敷 炎性肠梗阻 肠道屏障功能 血管活性肠肽 

分 类 号：R656.7[医药卫生—外科学] R269[医药卫生—临床医学]