疏肝利胆方对全麻腹腔镜胆囊切除术患者术后胃肠功能恢复及TLR4/NF-κB通路影响

Effect of Shugan Lidan Recipe on postoperative gastrointestinal function recovery and TLR4/NF-κB in patients undergoing laparoscopic cholecystectomy under general anesthesia channel influence

目的:探讨疏肝利胆方对全麻腹腔镜胆囊切除术患者术后胃肠功能恢复及Toll样受体4(TLR4)/核因子κB(NF-κB)通路影响。方法:选自衡水市第四人民医院收治的胆囊结石患者82例,均行全麻腹腔镜胆囊切除术,随机分为观察组41例与对照组41例。对照组患者均于术后采取常规治疗;观察组在对照组基础上结合疏肝利胆方治疗。比较2组患者术后胃肠功能恢复情况、炎性因子及TLR4、NF-κB mRNA表达情况。结果:观察组术后首次肛门排气时间、首次排便时间、胃肠蠕动恢复时间和首次进食时间快于对照组(P<0.05)。观察组术后7天胁痛或腹痛、恶寒发热、大便情况和小便情况积分低于对照组(P<0.05)。观察组术后7天血清TNF-α、CRP和IL-6水平低于对照组(P<0.05)。观察组术后7天TLR4和NF-κB mRNA表达低于对照组(P<0.05)。结论:全麻腹腔镜胆囊切除术患者采用疏肝利胆方可加快患者术后胃肠功能恢复,减轻中医症候,减轻炎性反应,及下调TLR4/NF-κB表达。

Objective:To investigate the effect of Shugan Lidan Recipe on the recovery of gastrointestinal function and toll like receptor 4(TLR4)/nuclear factorκB(NF-κB)in patients undergoing laparoscopic cholecystectomy under general anesthesia pathway impact.Methods:82 patients with gallstones admitted to the Fourth People's Hospital of Hengshui were selected,all of them underwent laparoscopic cholecystectomy under general anesthesia,and were randomly divided into observation group(41 cases)and control group(41 cases).The control group was treated with conventional treatment after operation;the observation group was treated with Shugan Lidan recipe on the basis of the control group.The recovery of gastrointestinal function,inflammatory factors and the expression of TLR4 and NF-κB mRNA were compared between the two groups.Results:The observation group first anal exhaust time,the first defecation time,the recovery time of gastrointestinal peristalsis and the first eating time faster than control group(P<0.05).The observation group scores of rib pain or abdominal pain,cold aversion and fever,stool and urination lower than control group 7 days after operation(P<0.05).The observation group serum TNF-α,CRP and IL-6 levers lower than control group(P<0.05).The observation group TLR4 and NF-κB mRNA expression lower than control group(P<0.05).Conclusion:Shugan Lidan decoction can accelerate the recovery of gastrointestinal function,reduce TCM symptoms,reduce inflammatory reaction and down regulate TLR4/NF-κB expression in patients undergoing laparoscopic cholecystectomy under general anesthesia.