中西药物联合治疗术后炎性肠梗阻40例

Treatment for 40 Cases of Postoperative Inflammatory Ileus with Integrative Medicine

目的:观察复方大承气汤联合西药常规治疗术后炎性肠梗阻的临床疗效。方法:将80例术后炎性肠梗阻患者随机分为治疗组、对照组各40例。2组均给予西医全身支持疗法、胃肠减压等常规治疗。观察组同时给予复方大承气汤及灌肠治疗。2组均以治疗3天为1个疗程,治疗2个疗程后观察2组治疗前后内毒素(LPS)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)的变化情况,以及腹痛缓解时间、腹胀缓解时间、肛门排气时间及排便时间,并评价临床疗效。结果:治愈率治疗组为52.50%,对照组为40.00%,2组相比有明显差异(P<0.05);总有效率治疗组为95.00%,对照组为87.50%,2组相比有明显差异(P<0.05)。治疗组腹痛缓解时间、腹胀缓解时间、肛门排气时间及排便时间均明显短于对照组,2组相比有明显差异(P<0.05)。LPS、hs-CRP、IL-6、TNF-α等炎症因子2组治疗后均明显改善(P<0.05);治疗组改善更明显(P<0.05)。2组均未出现明显不良反应。结论:复方大承气汤联合西药常规治疗术后炎性肠梗阻临床疗效显著,并可缩短腹痛缓解时间、腹胀缓解时间、肛门排气时间、排便时间,降低LPS、hs-CRP、IL-6、TNF-α等炎症因子水平。

Objective：To verify clinical effects of compound DaChengQiTang and routine treatment of western medicine in treating postoperative inflammatory ileus. Method：All 80 patients were randomized into the treatment group and the control group. Both groups received general support therapy of western medicine, routine treatment of gastrointestinal decompression. The observation group accepted compound DaChengQiTang and enema. Three days were one course of treatment, after two courses of treatment, the changes of LPS, IL-6, TNF-αand hs-CRP in both groups were observed before and after treatment as well as remission time of abdominal pain, remission time of ab-dominal distention, anal exhaust time and defection time clinical effects were assessed. Result：Cure rate of the treat-ment group was 52.50%, higher than 40.00%of the control group with significant difference （P〈0.05）. Total effec-tive rates of both groups were 95.00%and 87.50%, both groups showed significant difference （P〈0.05）. The treat-ment group was less than the control group in remission time of abdominal pain, remission time of abdominal disten-tion, anal exhaust time and defection time, the comparison showed significant difference （P〈0.05）. LPS, IL-6, TNF-αand hs-CRP of both groups were improved remarkably after treating （P〈0.05）;the treatment group was im-proved more significantly （P〈0.05）. There was no obvious adverse effects in both groups. Conclusion：Compound DaChengQiTang combined with routine treatment of western medicine are effective in treating postoperative inflam-matory ileus, the therapy could shorten remission time of abdominal pain, remission time of abdominal distention, anal exhaust time and defection time as well as decrease the levels of LPS, IL-6, TNF-αand hs-CRP.