理气通腑汤对妇科剖腹手术后患者胃肠功能恢复的影响

Influences of LiqiTongfu Decoction on the Postoperative Recovery of Gastrointestinal Function after Gynecological Laparotomy

目的:通过观察理气通腑汤对妇科剖腹手术后患者排气排便时间及相关症状、血清胃泌素(GAS)和一氧化氮(NO)的变化,探讨理气通腑汤对促进术后胃肠功能恢复的影响及其作用机理。方法:收集2010年4月～2011年2月在我院妇科住院行妇科剖腹手术患者56例(治疗组和对照组各28例)。治疗组于术后第1天起服用中药理气通腑汤,对照组不服用中药,两组术后常规处理相同。分别记录两组患者首次肛门排气排便时间以及术后恶心呕吐、腹胀腹痛等症状积分,并于术前、术后第1天、第3天测定血清GAS和NO的含量。结果:①术后排气及排便时间,治疗组明显短于对照组(P<0.05)。②术后恶心呕吐、腹胀腹痛症状积分的改善情况,治疗组明显优于对照组(P<0.05)。③术后血清GAS含量,治疗组明显高于对照组(P<0.05)。④术后NO含量,治疗组明显低于对照组(P<0.05)。⑤两组临床综合疗效,治疗组:显效率为64.29%,有效率为32.14%,总有效率96.43%;对照组:显效率21.43%,有效率39.29%,总有效率60.71%。治疗组明显优于对照组(P<0.05)。结论:理气通腑汤能缩短妇科腹部手术后患者排气、排便时间,改善患者术后腹胀腹痛、恶心呕吐等伴随症状,促进肠道细胞分泌胃泌素,抑制分泌一氧化氮,有利于促进患者手术后的胃肠功能恢复。

Objectives： This paper was to probe into the influence and mechanism of LiqiTongfu decoction on postoperative recovery of gastrointestinal function.Defecating time and related symptoms as well as the change of serum stomach secrete hormone（GAS）and nitric oxide（NO）were observed.Methods：56 cases of patients underwent gynecological laparotomy from April 2010 to February 2011 were randomly divided into treatment group and control group,each with 28 cases.Apart from the routine treatment given to the two groups,LiQiTongfu decoction was given to the control group on the first day post operation.The first exhaustion time,symptoms scores,GAS and NO on the 1st and 3rd day were respectively recorded.Results：1.The first exhaustion time post operation in treatment group was shorter than the control group（P0.05）.2.Symptom scores like vomiting and distention got better improvement in treatment group than the control group.（P0.05）.3.GAS in the treatment group was higher than the control group（P0.05）.4.NO in the treatment group was lower than the control group（P0.05）.5.As to the comprehensive effect,the treatment group showed 64.29% significant efficiency,32.14% of effective rate and 96.43% of total efficiency,compared to the 21.43%of significant efficiency 39.29% of effective rate and 60.71% of total efficiency in the control group（P0.05）.Conclusion： LiQiTongfu decoction can shorten the exhaustion time,improve postoperative abdominal symptoms like distension,abdominal pain,nausea and vomiting,as well as promote the secretion of GAS and inhibit the secretion of nitric oxide.As a result,it will promote the recovery of postoperative gastrointestinal function.