厚朴三物汤治疗结直肠癌术后早期炎性肠梗阻的疗效及对腹腔引流液中细胞因子的影响  

Therapeutic effect of Houpu Sanwu Decoction on early postoperative inflammatory intestinal obstruction of colorectal cancer and its impact on cytokines in abdominal drainage fluid

作　　者：王海华 胡莹[4] 葛小栋[2] 杨秀荣 谷丰[2] Wang Haihua;Hu Ying;Ge Xiaodong;Yang Xiurong;Gu Feng(Department of Bone Injury,Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,China;Department of Proctology,Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,China;Department of Acupuncture and Massage,Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,China;Department of Traditional Chinese Medicine,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]唐山市中医医院骨伤科,河北唐山063000 [2]唐山市中医医院肛肠科,河北唐山063000 [3]唐山市中医医院针灸推拿科,河北唐山063000 [4]中国医科大学附属盛京医院中医科,辽宁沈阳110004

出　　处：《实用药物与临床》2024年第11期837-840,共4页Practical Pharmacy and Clinical Remedies

基　　金：河北省中医药管理局科研计划项目(2024155)。

摘　　要：目的观察厚朴三物汤治疗结直肠癌术后早期炎性肠梗阻的疗效,以及对腹腔引流液中细胞因子的影响。方法选择唐山市中医医院2017年1月至2020年9月收治的106例结直肠癌术后早期炎性肠梗阻患者进行回顾性研究,根据用药不同分为对照组和观察组,各53例。对照组予以西医常规治疗加大黄,观察组在对照组西医常规治疗基础上,予厚朴三物汤治疗。持续治疗5 d后评估疗效。比较两组治疗有效率、康复进度指标和腹部体征变化、治疗前后腹腔引流液中细胞因子水平及不良反应发生情况。结果观察组临床有效率高于对照组(98.11%vs.84.90%,P<0.05);观察组呕吐停止时间、首次肛门排气时间、首次自主排便时间、梗阻后住院时间均明显短于对照组(P<0.05);观察组治疗48 h腹围缩小幅度、治疗48 h胃肠减压量均明显大于对照组,液气平消失时间明显短于对照组,差异均有统计学意义(P<0.05);观察组治疗5 d后腹腔引流液中降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α水平均低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05),且均未见严重不良反应,。结论厚朴三物汤治疗结直肠癌术后早期炎性肠梗阻的疗效确切,可有效促进胃肠功能恢复,降低腹腔引流液中细胞因子水平。Objective To observe the curative effect of Houpu Sanwu Decoction on early postoperative inflammatory intestinal obstruction of colorectal cancer and its impact on cytokines in abdominal drainage fluid.Methods A retrospective study was conducted on 106 patients with early postoperative inflammatory intestinal obstruction of colorectal cancer treated in Tangshan City Traditional Medical Hospital from January 2017 to September 2020.The patients were divided into control group and observation group according to different drug use,with 53 cases in each group.Control group was given conventional Western medicine treatment combined with unilateral rhubarb,and observation group was given Houpu Sanwu decoction on the basis of conventional Western medicine treatment.Both groups were treated continuously for 5 d to evaluate the efficacy.The effective rate,rehabilitation progress index,changes of abdominal signs and cytokine levels in peritoneal drainage before and after treatment,and the occurrence of adverse reactions were compared between the two groups.Results The clinical effective rate of observation group was higher than that of control group(98.11%vs.84.90%,P<0.05).The vomiting cessation time,first anal exhaust time,first spontaneous defecation time,and hospitalization time after intestinal obstruction in observation group were shorter than those in control group(P<0.05);the decrease in abdominal circumference and the gastrointestinal decompression volume at 48 h of treatment were bigger in observation group than in control group,and the disappearance time of fluid and gas levels was shorter than that of control group(P<0.05).The levels of calcitonin(PCT),C-reactive protein(CRP)and tumor necrosis factor(TNF)-alpha in abdominal drainage fluid in observation group were lower than those in control group at 5 d after treatment(P<0.05).There were no significant differences in the incidence rate of adverse reactions between the two groups(P>0.05),and no serious adverse reactions were observed in the two groups.Conclusion

关 键 词：结直肠癌 炎性肠梗阻 厚朴三物汤 腹腔引流液 细胞因子 

分 类 号：R273[医药卫生—中西医结合]