胃大部切除术后莱菔承气汤灌肠对胃肠功能及血清瘦素的影响

Effect of Laifu Chengqi decoction on gastrointestinal function and leptin secretion after BillrothⅡ-type surgery

目的观察胃大部切除术后莱菔承气汤灌肠对胃肠功能及血清瘦素的影响。方法将40例胃大部切除术患者随机分为治疗组(20例)、对照组(20例)2组,同时选择20例门诊健康体检者作为正常组。对照组术后予常规治疗,治疗组在对照组治疗基础上加莱菔承气汤灌肠。观察2组手术患者术后排气、排便时间,分别于术前1 d及术后第1、3、5 d观察3组胃电图的(EGG)主频(DF)、正常慢波百分比(N%)变化及血清瘦素变化。结果治疗组术后排气、排便时间均较对照组提前(P<0.05)。治疗组术后第1、3 dEGG的DF、N%较术前下降(P<0.05),血清瘦素较术前升高(P<0.05),术后第5 d与术前比较差异无统计学意义(P>0.05)。对照组术后第1、3、5 d EGG的DF、N%均较术前下降(P<0.05),血清瘦素均较术前升高(P<0.05)。治疗组、对照组术后同期EGG的DF均较正常组下降(P<0.05)。治疗组术后第1、3 d,对照组术后第1、3、5 d EGG的N%均较正常组同期下降(P<0.05),血清瘦素均较正常组同期升高(P<0.05)。治疗组术后第3、5 d EGG的DF、N%较对照组同期升高(P<0.05),血清瘦素较对照组同期降低(P<0.05)。结论胃大部切除术后莱菔承气汤术后灌肠可促进胃肠功能的恢复,与调节内源性血清瘦素的水平关系密切。

Objective To investigate the effect of Laifu Chengqi decoction on gastrointestinal function and leptin secretion after Billroth H - type surgery. Methods 40 cases were studied after Billroth lI - type surgery, which were randomly divided into treatment group and control group, 20 cases were selected as normal group. Control group received conventional treatment. Treatment group received enema of Laifu Chengqi decoction on the basis of conventional treatment. The time of exhaust and defecation, dominant frequency （DF） of electrogastrogram （ EGG）, percentage of normal slow wave （ N% ） and serum leptin were measured at 1 day before surgery and on 1,3,5 days post operation. Results The time of exhaust and defecation in treatment group was earlier than that in control group （P 〈 O. 05）. DF and N% on 1 and 3 days post operation was decreased as compared with that before operation in treatment group（P 〈 0.05 ）. The level of serum leptin was increased （P 〈0.05）. There was no significant between before and 5 day post operation on DF, N% and serum leptin （ P 〉0.05）. DF and N% on 1,3 and 5 days post op- eration was decreased as compared with that before operation in control group（P 〈 0. 05 ）. The level of serum leptin was increased （P 〈 O. 05 ）. DF in treatment group and control group was decreased in comparison with that normal group over the same period after surgery （P 〈 0.05）. N% on 1 and 3 days post operation of treatment group and on 1,3 and 5 days post operation of control group was decreased （P 〈 0.05）. The level of serum leptin was increased in comparison with that normal group over the same period （P 〈 0.05）. DF and N% on 3 and 5 days post operation of treatment group was increased as compared with that normal group over the same period after surgery （ P 〈 0.05 ）. Serum leptin in treatment group was raised as compared with that in control group（P〈0.05）. Conclusion Laifu Chengqi decoction can promote gastrointestinal function recovery significantly, and was positively correlated with the regulation of leptin secretion.