胃复春联合加味桃核承气汤治疗胃、十二指肠溃疡穿孔术后早期炎症性肠梗阻临床研究  

Clinical Study on Weifuchun Combined with Modified Taohe Chengqi Decoction for Early Inflammatory Intestinal Obstruction After Perforation of Gastric and Duodenal Ulcer

作　　者：肖广远 黄文艳 吴海俊 周君 肖卫星 陈炳荣 周海军 顾梦佳 XIAO Guangyuan;HUANG Wenyan;WU Haijun;ZHOU Jun;XIAO Weixing;CHEN Bingrong;ZHOU Haijun;GU Mengjia(Department of General Surgery,Jiaxing Traditional Chinese Medicine Hospital,Jiaxing Zhejiang 314015,China;Laboratory department,Jiaxing Traditional Chinese Medicine Hospital,Jiaxing Zhejiang 314015,China)

机构地区：[1]嘉兴市中医院普外科,浙江嘉兴314015 [2]嘉兴市中医院检验科,浙江嘉兴314015

出　　处：《新中医》2024年第16期56-61,共6页New Chinese Medicine

基　　金：浙江省医学会临床科研基金项目(2022ZYC-A44)。

摘　　要：目的:观察胃复春联合加味桃核承气汤对胃肠道穿孔术后早期炎症性肠梗阻患者的恢复效果及对血清学指标的影响。方法:选取60例胃肠道溃疡穿孔术后早期炎症性肠梗阻患者作为研究对象,按随机数字表法分为对照组和试验组各30例。2组均进行胃肠道溃疡穿孔修补术,对照组给予术后常规治疗,试验组在对照组的基础上给予胃复春联合加味桃核承气汤治疗。治疗2周后,比较2组临床疗效及术后恢复情况,治疗前后血清炎症指标[超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)]、血清胃肠激素[胃泌素(GAS)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)]水平及不良反应发生情况。结果:治疗后,试验组总有效率为93.33%,高于对照组70.00%,2组比较,差异有统计学意义(P<0.05)。试验组腹痛改善时间、腹胀缓解时间、首次排气时间、首次排便时间及肠鸣音恢复时间均短于对照组(P<0.05)。治疗后,2组血清hs-CRP、TNF-α、IL-6水平均较治疗前降低(P<0.05),且试验组各项炎症指标均低于对照组(P<0.05)。治疗后,2组血清GAS水平较治疗前降低(P<0.05),PGⅠ、PGⅡ水平较治疗前升高(P<0.05);且试验组GAS水平低于对照组(P<0.05),PGⅠ、PGⅡ水平高于对照组(P<0.05)。试验组不良反应发生率为6.67%,对照组为13.33%,2组比较,差异无统计学意义(P>0.05)。结论:胃复春联合加味桃核承气汤可有效调节胃肠道溃疡穿孔术后患者血清学指标水平,减轻炎症反应,改善胃肠功能,有利于促进患者症状恢复,提高临床疗效,且用药安全性良好。Objective:To observe the recovery effect of Weifuchun combined with modified Taohe Chengqi Decoction on patients with early inflammatory intestinal obstruction after gastrointestinal ulcer perforation,and its effect on serological indicators.Methods:A total of 60 cases of patients with early inflammatory intestinal obstruction after gastrointestinal ulcer perforation were selected as the study subjects,and which were randomly divided into the control group and the trial group,with 30 cases in each group,using a random number table method.Both groups underwent gastrointestinal ulcer perforation repair surgery.The control group received routine postoperative treatment,and the trail group received treatment with Weifuchun combined with modified Taohe Chengqi Decoction on the basis of the control group.After two weeks of treatment,the clinical effects and postoperative recovery between the two groups,as well as the serum inflammatory markers[hyper sensitive C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α),and interleukin-6(IL-6)],serum gastrointestinal hormone indicators[gastrin(GAS),pepsinogenⅠ(PGⅠ),and pepsinogenⅡ(PGⅡ)]levels,and incidence of adverse reactions were compared before and after treatment.Results:After treatment,the total effective rate was 93.33%in the trial group,which was higher than that of 70.00%in the control group,the difference being significant(P<0.05).The improvement time of abdominal pain,relief time of abdominal distension,first exhaust time,first defecation time,and recovery time of bowel sounds in the trial group were shorter than those in the control group(P<0.05).After treatment,the levels of hs-CRP,TNF-αand IL-6 in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the serum inflammatory indicators in the trial group were lower than those in the control group(P<0.05).After treatment,the levels of serum GAS in the two groups were decreased when compared those before treatment(P<0.05),and the levels of PGⅠand PGⅡwere incr

关 键 词：炎症性肠梗阻 胃肠道溃疡穿孔 围手术期 胃复春 加味桃核承气汤 灌肠 胃肠激素 

分 类 号：R574.2[医药卫生—消化系统]