穴位灸罐法对妇科腹部手术后胃肠激素表达及胃肠功能恢复的影响

Effect of acupuncture moxibustion tank method on expression of gastrointestinalhormones and recovery of gastrointestinal function in patients after gynecological abdominal surgery

目的 探讨穴位灸罐法对妇科腹部手术后胃肠功能恢复期胃动素（MTL）、胃泌素（GAS）表达的影响.方法 将64例符合纳入标准的患者按照随机数字表法随机分为对照组与研究组各32例.对照组采用妇科术后常规护理方法,研究组在此基础上采用穴位灸罐法.检测患者术前24h、术后24,48h的MTL及GAS水平,观察两组患者术后第1次肛门排气、排便时间,腹胀发生及其程度,有无恶心、呕吐、术后肠梗阻等情况.结果 研究组腹胀无、1级、2级、3级例数分别为21,8,3,0例,对照组分别为10,12,8,2例,两组比较差异有统计学意义（Z=-2.926,P＜0.05）.研究组术后第1次肛门排气、排便时间分别为（35.50±10.04）,（55.41±11.77）h,对照组分别为（42.81±16.93）,（77.66±22.56）h,两组比较差异均有统计学意义（t值分别为-2.102,-4.946;P ＜0.05）.研究组术后24,48 h MTL水平分别为（642.32±347.70）,（618.91±221.53） pg/ml,GAS水平分别为（58.14±36.01）,（67.06±47.37） pg/ml;对照组MTL水平分别为（542.81±236.58）,（558.83±230.63） pg/ml,GAS水平分别为（56.99±43.74）,（63.17±49.52） pg/ml,两组比较差异均无统计学意义（t值分别为1.339,1.063,0.114,0.321；P＞0.05）.结论 穴位灸罐法能促进妇科腹部术后胃肠功能恢复,但对MTL、GAS表达影响不显著.

Objective To explore the effect of acupuncture moxibustion tank method on expression of motilin（MTL） and gastrin（GAS） in the recovery of gastrointestinal function in patients after gynecological abdominal surgery.Methods Totals of 64 patients were chosen and randomly divided into the control group and the treatment group,each with 32 cases.The control group received conventional gynecological nursing while the treatment group received acupuncture moxibustion tank method in addition.MTL and GAS 24 hours before surgery,24 and 48 hours after surgery were detected,and patients＇ postoperative first anal exhaust,defecation time,incidence and severity of abdominal distension,nausea,vomiting and postoperative ileus were observed in both groups.Results The number of non,first degree,second degree and third degree of abdominal distension was respectively 21,8,3 and 0 in the treatment group,and 10,12,8 and 2 in the control group,with statistically significant difference （Z =-2.926,P ＜ 0.05）.Patients＇ postoperative first anal exhaust and defecation time was （35.50 ± 10.04）h and（55.41 ± 11.77） h in the treatment group,and （42.81 ± 16.93） h and（77.66 ± 22.56） h in the control group,with statistically significant differences （t =-2.102,-4.946,respectively; P ＜ 0.05）.MTL 24 and 48 hours after surgery was respectively （642.32 ± 347.70）,（618.91 ±221.53） pg/ml,GAS 24 and 48 hours after surgery was respectively（58.14 ± 36.01）,（67.06 ± 47.37） pg/ml in the treatment group,and（542.81 ±236.58）,（558.83 ±230.63） pg/ml and （56.99 ±43.74）,（63.17 ±49.52） pg/ml in the control group,with no statistically significant differences（t =1.339,1.063,0.114,0.321,respectively; P ＞ 0.05）.Conclusions Acupuncture moxibustion tank method can promote the recovery of gastrointestinal function in patients after gynecological abdominal surgery,without obvious effect on MTL and GAS.