中药粘连松解汤联合粘连松解术对粘连性肠梗阻患者的临床疗效及疼痛程度与炎症指标的影响  

Effect of Traditional Chinese Medicine adhesive loose decoction combined with adhesiolysis on the clinical efficacy,pain degree and inflammatory index of patients with adhesive intestinal obstruction

作　　者：杨宗林 张东 YANG Zonglin;ZHANG Dong(Department of Emergency Surgery,Jiujiang NO.1 People's Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院急诊外科,江西九江332000

出　　处：《当代医学》2024年第24期58-62,共5页Contemporary Medicine

摘　　要：目的探讨中药粘连松解汤联合粘连松解术对粘连性肠梗阻(adhesive intestinal obstruction,AIO)患者的临床疗效、疼痛程度与炎症指标的影响。方法选取2021年1—12月九江市第一人民医院收治的60例AIO患者作为研究对象,按照随机投掷法分为对照组与观察组,每组30例。对照组采用传统开腹肠粘连松解术治疗,观察组在对照组基础上联合中药粘连松解汤治疗。比较两组临床疗效、术后恢复情况与手术前后炎症指标[前白蛋白(prealbumin,PA)、降钙素原(procalcitonin,PCT)、C反应蛋白(C-reaction protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-10(interleukin-10,IL-10)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]及术后并发症发生率和复发率。结果观察组治疗总有效率为96.67%,高于对照组的73.33%,差异有统计学意义(P<0.05)。观察组术后排便时间、术后排气时间、首次下床活动时间、腹胀腹痛消失时间、住院时间均短于对照组,术后48 h视觉模拟评分法(visual analog scale,VAS)低于对照组,差异有统计学意义(P<0.05)。术后,两组血清PA水平均高于术前,血清PCT、IL-6、IL-10、TNF-α、CRP水平均低于术前,且观察组血清PA水平高于对照组,血清IL-6、IL-10、TNF-α、CRP水平均低于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率、复发率均低于对照组,差异有统计学意义(P<0.05)。结论开腹肠粘连松解术联合中药粘连松解汤治疗AIO的效果显著,可促进患者胃肠功能恢复,减轻患者术后疼痛感,降低机体炎症因子水平及术后并发症发生率、复发率,值得临床推广应用。Objective To investigate clinical efficacy of Traditional Chinese Medicine adhesive loose decoction combined with adhesiolysis on on the clinical efficacy,pain degree and inflammatory index of patients with adhesive intestinal obstruction(AIO).Methods 60 AIO patients admitted to the Jiujiang NO.1 People's Hospital from January to December 2021 were selected as the research subjects,and they were divided into the control group and the observation group according to the throwing method,with 30 cases in each group.The control group was treated with traditional open intestinal adhesiolysis,while the observation group was treated with Traditional Chinese Medicine adhesiolysis loose decoction based on the control group,the clinical efficacy,postoperative recovery,preoperative and postoperative inflammatory indicators(prealbumin[PA],procalcitonin[PCT],C-reactive protein[CRP],interleukin-6[IL-6],interleukin-10[IL-10],tumor necrosis factor-α[TNF-α]),the incidence of postoperative complications and recurrence rates were compared between two groups.Results The total effective rate in the observation group was 96.67%,which was higher than 73.33%in the control group,the difference was statistically significant(P<0.05).The postoperative defecation time,postoperative exhaust time,first time of getting out of bed,abdominal distension and pain disappearance time,hospitalization time in the observation group were shorter than those in the control group,and the visual analog scale(VAS)scores at 48 h after operation was lower than that in the control group,the differences were statistically significant(P<0.05).After operation,the serum levels of PA of the two groups were higher than that before operation,and the serum levels of PCT,IL-6,IL-10,TNF-αand CRP were lower than those before operation,and the serum level of PA in the observation group was higher than that in the control group,and the serum levels of PCT,IL-6,IL-10,TNF-αand CRP were lower than those in the control group,the differences were statistically significant(P<0.

关 键 词：中药粘连松解汤 粘连性肠梗阻 粘连松解术 炎症指标 

分 类 号：R73[医药卫生—肿瘤]