复方大承气汤对全胃切除后消化道重建患者预后恢复的影响

Study on effect of Fufang Dachengqi Tang in rehabilitation of patients with digestive tract reconstruction after total gastrectomy

目的探讨中药复方大承气汤对全胃切除后消化道重建患者预后恢复的影响。方法选择2010年1月至2011年1月治疗的200例胃癌患者,所有患者行全胃切除术后随机将其分为P型空肠袢食管空肠Roux-en-Y吻合术组(PRY组,100例)和中药联合PRY组(100例),记录两组患者肛门排气时间、手术并发症及营养学指标,以此评价中药对患者预后恢复的影响。结果与PRY组比较,中药联合PRY组肛门排气时间、拔胃管前胃肠引流液总量、手术并发症、病死率、进食次数及GSRS评分均较低,体重变化、总蛋白、预后营养指数、进食量均上升,差异有统计学意义(P<0.05);两组白蛋白、血红蛋白比较,差异无统计学意义(P>0.05)。结论中药复方大承气汤可降低全胃切除后消化道重建患者并发症发生率及病死率,减少胃肠内液潴留及肠粘连,改善患者的生活质量,值得临床推广。

Objective To explore the effect of Fufang Dachengqi Tang （decoction） in recovery of patients with digestive tract reconstruc- tion after total gastrectomy. Methods A total of 200 patients with P type Roux - enY esophagojejunostomy after gastrectomy during January 2010 to January 2011 in this hospital were chosen and randomly assigned to PRY group （ 100 cases） and traditional Chinese medicine treated PRY group （ 100 cases）. The anal exhaust time, surgical complications and nutrition index were recorded to evaluate the outcome of patients treated with tra- ditional Chinese medicine on their recovery. Results In comparison with PRY group, the anal exhaust time, amount of gastrointestinal drainage fluid before drawing out stomach tube, surgical complications, mortality, feeding frequency and GSRS scores in patients of traditional Chinese med- icine with PRY group were decreased, weight change, total protein and prognostic nutrition index, and food intake were increased （ P 〈 O. 05 or P 〈 0.01 ） ; The difference in blood levels of albumin and hemoglobin between these 2 groups was not statistically significant （ P 〉0.05 ）. Conclu- sion Fufang Dachengqi Tang can reduce the rates of complications and mortality in patients with digestive tract reconstruction after total gastrecto- my, and it may reduce the intestine fluid retention and intestinal adhesion, and improve the quality of life of patients, hence it is worthy for clinical promotion.