胃癌空肠间置术后中药治疗对早期胃肠功能恢复的效果研究

Effect of Chinese Medicine in Early Recovery of Gastrointestinal Function in Patients with Gastric Cancer Treated with Modified Double Tracks Anastomosis

目的观察胃癌患者空肠间置术后应用自制九味承气口服液对胃肠功能恢复的效果,并据此提出相关治疗护理措施。方法选取2010—2011年在河北医科大学第四医院外三科行胃癌根治空肠间置术患者85例,将其随机分为对照组(40例)和中药组(45例),两组均给予外科术后常规护理、胃肠减压、抗感染及对症治疗,维持水电解质平衡,鼓励患者早下床活动。此外,中药组术后24 h开始给予九味承气口服液,20 ml/次,2次/d。观察两组患者术后腹胀、腹痛、恶心、呕吐等不适感,胃液引流量,肠鸣音频率,术后排气、排便时间,用药不良反应及近期并发症发生情况,均观察1周。结果术后两组患者不适感发生率(77.5%与64.4%)间差异无统计学意义(P>0.05);中药组患者胃液引流量(344±70)ml/d少于对照组(455±80)ml/d,肠鸣音频率(4.3±1.8)次/min高于对照组(2.2±1.1)次/min,排气、排便时间〔(68.2±22.3)h、(77.3±26.4)h〕,短于对照组〔(79.5±27.6)h、(92.6±30.5)h〕,差异有统计学意义(P均<0.05)。中药组用药未见明显不良反应;其近期并发症发生率为6.7%(3/45),与对照组的10.0%(4/40)比较,差异无统计学意义(P>0.05)。中药组术后住院时间(10.5±3.3)d,短于对照组(13.9±4.2)d,差异有统计学意义(P<0.05)。结论胃癌空肠间置术后早期应用中药九味承气口服液,可促进患者胃肠功能恢复并对患者的整体康复有良好作用。

Objective To investigate the effect of nine compounds oral liquid in early recovery of gastrointestinal function in patients with gastric cancer treated with modified double tracks anastomosis. Methods Data of 85 gastric cancer casestreated with modified double tracks anastomosis from 2010 to 2011 were collected. The patients were divided into control group（40 cases） and traditional Chinese medicine （TCM） group （45 cases） . The two groups were both given routine nursing, gastrointestinal decompression,anti - infection and symptomatic treatment,maintaining water electrolyte balance,and patients wereencouraged to move as early as possible. The TCM group was also given nine compounds oral liquid twice a day with each time 20ml since 24 h postoperation. Data of bellyache,bloating,gastric drainage,frequency of bowel sounds,time of exhaust defecation ,adverse reaction and complications were collected and compared between the two groups. Results The incidence of discomfort after the operation （77. 5% vs. 64. 4% ） between the two groups showed no statistically significant difference （P 〉 0. 05 ）.The gastric drainage〔 （344 ±70） ml/d vs. （455 ±80） ml/d],bowel sounds〔 （4. 3 ± 1. 8） time/min vs. （2. 2 ± 1. 1 ） time/min] and time of exhaust defecation 〔 （68. 2 ±22.3） h vs. （79. 5 ±27.6） h, （T7.4） h vs. （92. 6 ±30.5） h] allshowed statistically significant differences between TCM group and control group （ P 〈 0. 05 ） . No adverse effect was found inTCM group. The complication rate of TCM group and control group〔6.1% （3/45） vs. 10. 0% （4/40）〕showed no statisticallysignificant difference （P 〉0. 05） . The hospital stay of TCM group and control group〔 （10. 5 ± 3. 3 ） d vs. （13. 9 ±4. 2） d] showed statistically significant difference （ P 〈 0. 05 ） . Conclusion Nine compounds oral liquid has excellent effect in early re-covery of gastrointestinal function in patients with gastric cancer treated with modified double tracks anastomosis.