清腹通肠颗粒对腹腔镜下阑尾切除术后早期炎性肠梗阻的疗效  

Efficacy of Qingfu Tongchang Granule on early postoperative inflammatory small bowel obstruction after laparoscopic appendectomy

作　　者：张习禄 孙建飞 周军 司明明 张迪 肖刚 ZHANG Xilu;SUN Jianfei;ZHOU Jun;SI Mingming;ZHANG Di;XIAO Gang(Department of General Surgery,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang,Shaanxi 712000,China)

机构地区：[1]陕西中医药大学附属医院普外科,陕西咸阳712000 [2]陕西中医药大学继续教育学院,陕西咸阳712099 [3]陕西中医药大学,陕西咸阳712046

出　　处：《中国临床研究》2024年第11期1765-1769,共5页Chinese Journal of Clinical Research

基　　金：陕西省卫生健康科研基金项目(2018A017);陕西中医药大学附属医院科研课题(2020ZJ003)。

摘　　要：目的探究清腹通肠颗粒对腹腔镜下阑尾切除术后早期炎性肠梗阻(EPISBO)患者临床症状、免疫功能及胃肠功能的改善作用。方法选取2021年6月至2023年6月110例于陕西中医药大学附属医院治疗的腹腔镜下阑尾切除术后EPISBO患者,随机分为对照组和观察组,每组55例。对照组给予常规对症治疗;观察组在对照组常规治疗基础上口服清腹通肠颗粒。对比两组治疗前后中医证候积分(TCMSS)、炎症指标[白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)]、免疫指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、胃肠功能(胃肠激素水平和胃肠功能恢复时间)的差异,及临床疗效和不良反应。结果观察组临床治疗总有效率高于对照组(92.72%vs 76.36%,χ^(2)=5.636,P<0.05)。治疗后,两组TCMSS低于治疗前,且观察组低于对照组(P<0.05)。观察组胃动素水平高于对照组,胃泌素水平低于对照组,患者胃肠功能恢复时间均短于对照组(P<0.05);两组TNF-α、IL-6水平低于治疗前,且观察组低于对照组(P<0.05);两组CD4^(+)、CD4^(+)/CD8^(+)比值高于治疗前,CD8^(+)低于治疗前(P<0.05)。与对照组相比,观察组CD4^(+)和CD4^(+)/CD8^(+)比值升高,CD8^(+)降低(P<0.05)。两组总不良反应发生率比较差异无统计学意义(P>0.05)。结论清腹通肠颗粒可有效提高阑尾切除术后EPISBO患者的临床疗效,促进胃肠功能恢复,提高免疫功能,抑制炎症反应,且安全性良好。Objective To explore the effect of Qingfu Tongchang Granule on clinical symptoms,immune function and gastrointestinal function of patients with early postoperative inflammatory small bowel obstruction(EPISBO)after laparoscopic appendectomy.Methods A total of 110 patients with EPISBO after laparoscopic appendectomy in Affiliated Hospital of Shaanxi University of Chinese Medicine from June 2021 to June 2023 were selected and randomly divided into control group and observation group,with 55 cases in each group.The control group was given conventional symptomatic treatment.The observation group was given Qingfu Tongchang Granule by oral administration on the basis of conventional treatment in the control group.The TCM syndrome score(TCMSS),inflammatory indexes[interleukin-6(IL-6),tumor necrosis faction-α(TNF-α)],immune indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),gastrointestinal function(gastrointestinal hormone levels and gastrointestinal function recovery time)before and after treatment,as well as the clinical efficacy and adverse reactions were compared between the two groups.Results The total clinical effective rate in the observation group was higher than that in the control group(92.72%vs 76.36%,χ^(2)=5.636,P<0.05).After treatment,the TCMSS of the two groups were significantly reduced,and the TCMSS of the observation group was lower than that of the control group(P<0.05).Compared with control group,the level of motilin significantly increased,the level of gastrin significantly decreased in the observation group(P<0.05).In addition,the recovery time of gastrointestinal function in the observation group were significantly shorter than those in the control group(P<0.05).Compared with before treatment,the levels of TNF-αand IL-6 were significantly decreased in the two groups after treatment,and the levels of TNF-αand IL-6 in the observation group were significantly lower than those in the control group(P<0.05).After treatment,compared with before treatment,the level of CD4^(+)and CD44/CD8^(+)of the two groups wer

关 键 词：清腹通肠颗粒 术后早期炎性肠梗阻 胃肠功能 免疫功能 炎症反应 

分 类 号：R656.7[医药卫生—外科学] R285.6[医药卫生—临床医学]