血府逐瘀汤加味联合隔药灸治疗肠粘连临床观察

Modified Xuefu Zhuyu Decoction Combined with Medicine-separated Moxibustion in the Treatment of Postoperative Intestinal Adhesion

目的探讨血府逐瘀汤加味联合隔药灸治疗术后肠粘连的临床效果。方法将122例术后肠粘连患者随机分为对照组和试验组,每组61例。对照组给予常规对症处理及枸橼酸莫沙必利片、颠茄片治疗,试验组在对照组基础上给予血府逐瘀汤加味联合隔药灸治疗,两组均治疗3周。比较两组临床疗效、腹痛程度评分、血清炎性细胞因子及肠道屏障功能指标水平。结果治疗后,试验组总有效率为90.16%(55/61),高于对照组的73.77%(45/61)(P<0.05)。与对照组比较,试验组治疗后疼痛分级指数(PRI)、视觉模拟量表(VAS)及现时疼痛强度(PPI)评分均较低,血清肿瘤坏死因子(TNF-α)、白细胞介素-1(IL-1)及白细胞介素-6(IL-6)水平较低,血清D-乳酸、二胺氧化酶(DAO)水平较低,谷氨酰胺(GLN)水平较高(P<0.05)。结论血府逐瘀汤加味联合隔药灸治疗术后肠粘连的临床效果显著,能明显减轻腹痛症状、抑制炎症反应、促进肠黏膜屏障功能恢复,具有临床推广应用价值。

Objective To investigate the clinical effect of modified Xuefu Zhuyu decoction combined with medicine-separated moxi-bustion in the treatment of postoperative intestinal adhesion.Methods One hundred and twenty-two patients with postoperative intes-tinal adhesion were randomly divided into control group and treatment group,with 61 cases in each group.The control group was treated with routine symptomatic treatment and mosapride citrate tablets and belladonna tablets,and the treatment group was treated with modified Xuefu Zhuyu decoction combined with medicine-separated moxibustion on the basis of the control group.The two groups were both treated for 3 weeks.The clinical efficacy,abdominal pain score,serum levels of inflammatory cytokines and intesti-nal barrier function were compared between the two groups.Results After treatment,the total effective rate of the treatment group was 90.16%(55/61),which was higher than that of the control group(73.77%,45/61)(P<0.05).Compared with the control group,the scores of pain rating index(PRI),visual analogue scale(VAS)and present pain intensity(PPI)were lower,the serum levels of tumor necrosis factor-α(TNF-α),interleukin-1(IL-1)and interleukin-6(IL-6)were lower,the levels of serum D-lactic acid and diamine oxidase(DAO)were lower,and the levels of glutamine(GLN)was higher in the treatment group after treatment(P<0.05).Conclusion Modified Xuefu Zhuyu decoction combined with medicine-separated moxibustion has a significant clinical effect in the treatment of postopera-tive intestinal adhesion,which can significantly reduce the symptoms of abdominal pain,inhibit inflammatory reaction and promote the recovery of intestinal mucosal barrier function,and has the value of clinical popularization and application.