加味小承气汤保留灌肠联合中药封包对急性低位肠梗阻患者肠屏障功能和血炎性因子的影响  

Effects of Modified Xiaochengqi Decoction(加味小承气汤)Retention Enema Combined with TCM Packaging on Intestinal Barrier Function and Serum Inflammatory Factors in Patients with Acute Low Intestinal Obstruction

作　　者：王建斌 余小勇 吉涛 WANG Jianbin;YU Xiaoyong;JI Tao(Department of Emergency Surgery,Suzhou Hospital of Integrated Traditional Chinese and Western Medicine,Suzhou 215100,Jiangsu,China)

机构地区：[1]苏州市中西医结合医院急诊外科,江苏苏州215100

出　　处：《辽宁中医杂志》2024年第11期90-94,共5页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的探讨加味小承气汤保留灌肠联合中药封包对急性低位肠梗阻患者肠屏障功能和血炎性因子的影响。方法选取该院2021年1月—2023年1月126例急性低位肠梗阻患者,随机分为观察组与对照组,每组63例患者,两组均给予常规西医治疗,在此基础上对照组给予中药封包治疗,观察组给予加味小承气汤保留灌肠联合中药封包治疗,比较两组临床疗效、临床症状改善时间、中医证候积分、胃肠动力功能、肠屏障功能、免疫与炎性指标水平。结果观察组临床治疗有效率96.83%(61/63)高于对照组85.71%(54/63)(P<0.05);观察组肠鸣音恢复时间、肛门排气时间、排便时间、X线肠腔积气消失时间短于对照组(P<0.05);观察组治疗后大便秘结、腹胀疼痛、午后潮热、手足汗出、失眠多梦证候积分低于对照组(P<0.05);观察组治疗后血清胃肠动力功能指标血管活性肠肽(vasoactive intestinal peptide,VIP)水平低于对照组,胃泌素、胃动素水平高于对照组(P<0.05);观察组治疗后血清肠屏障功能二胺氧化酶(diamine oxidase,DAO)、D-乳酸水平低于对照组(P<0.05);观察组治疗后外周血T淋巴细胞CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平高于对照组,CD_(8)^(+)水平低于对照组(P<0.05);观察组治疗后血清炎性指标白介素6(interleukin-6,IL-6)、肿瘤坏死因子α(necrosis factorα,TNF-α)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平低于对照组(P<0.05)。结论加味小承气汤保留灌肠联合中药封包治疗有利于减轻急性低位肠梗阻患者临床症状,提高胃肠动力和肠屏障功能,降低炎性反应,增强机体免疫,加快患者康复进程,疗效显著。Objective To explore the effects of modified Xiaochengqi Decoction(加味小承气汤)retention enema combined with TCM packaging on intestinal barrier function and serum inflammatory factors in patients with acute low intestinal obstruction.Methods A total of 126 patients with acute low intestinal obstruction in the hospital were enrolled and randomly divided into observation group and control group between January 2021 and January 2023,63 cases in each group.On basis of routine western medicine,the control group was treated with TCM packaging,while the observation group was treated with Modified Xiaochengqi Decoction retention enema on basis of control group.The clinical curative effect,the improvement time of clinical symptoms,the scores of TCM syndromes,the gastrointestinal motility function,the intestinal barrier function,the immune and inflammatory indexes were compared between the two groups.Results The response rate of the clinical treatment in the observation group was higher than that in the control group[96.83%(61/63)vs 85.71%(54/63),P<0.05].The recovery time of bowel sound,anal exhaust time,defecation time and disappearance time of X-ray intestinal gas in the observation group were shorter than those in the control group(P<0.05).After treatment,the scores of TCM syndromes(constipation,abdominal distension and pain,afternoon tidal fever,sweating of hands and feet,insomnia and dreaminess)in the observation group were lower than those in the control group(P<0.05).After treatment,the level of serum vasoactive intestinal peptide(VIP)in the observation group was lower than that in the control group,while the levels of gastrin and motilin were higher than those in the control group(P<0.05).After treatment,the levels of diamine oxidase(DAO)and D-lactic acid in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of peripheral blood CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+) in the observation group were higher than those in the control group,while CD_(8)^(+) was lower t

关 键 词：低位肠梗阻 加味小承气汤 保留灌肠 中药封包 肠屏障功能 

分 类 号：R256.3[医药卫生—中医内科学]