大承气汤保留灌肠联合针刺治疗对腹部手术后胃肠功能恢复的影响

Effect of Dachengqi decoction retention enema combined with acupuncture on the recovery of gastrointestinal function after abdominal surgery

目的探讨大承气汤保留灌肠联合针刺治疗对腹部手术后患者肠功能恢复的影响。方法将179例腹部手术患者按照分层随机分组法分为3组。针刺组51例,给予针刺治疗;灌肠组67例,给予大承气汤保留灌肠治疗;联合组61例,给予大承气汤保留灌肠联合针刺治疗。分别观察3组疗效,并比较3组肠鸣音恢复时间、肛门排气时间、排便时间、饮食恢复时间、住院天数及治疗前后血清二胺氧化酶(DAO)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)水平的变化。结果联合组总有效率均高于针刺组、灌肠组(P<0.05);联合组肠鸣音恢复时间、肛门排气时间、排便时间、饮食恢复时间及住院天数均短于针刺组、灌肠组;3组治疗后血清DAO、TNF-α、IL-6及CRP水平与本组治疗前比较均有明显降低(P<0.05),且联合组治疗后血清DAO、TNF-α、IL-6及CRP水平均低于针刺组、灌肠组(P<0.05)。结论大承气汤保留灌肠联合针刺治疗对腹部手术后胃肠功能恢复具有协同作用,能显著促进腹部手术患者肠功能恢复,提高临床疗效,在临床应用中具有重要价值。

Objective To explore the effect of Dachengqi decoction retention enema combined with acupunc -ture on the recovery of gastrointestinal function after abdominal surgery .Methods 179 patients with abdominal sur-gery according to stratified randomization were divided into acupuncture group , which received acupuncture treat-ment, enema group, which received Dachengqi decoction retention enema and combination group , which received Dachengqi decoction retention enema combined with acupuncture .The therapeutic effect was observed in three groups.Recovery time of bowel sounds , flatus, defecation, diet recovery time, and hospital stay were compared .The changes of DAO, IL-6, TNF-αand CRP before and after treatment were recorded .Results The total effective rate in combination group was higher than that in acupuncture group and enema group （ P 〈0.05 ） .The recovery time of bowel sounds, flatus, defecation, diet recovery time, hospital stay in combination group was shorter than that in acupuncture group and enema group .The levels of DAO, IL-6, TNF-αand CRP after treatment were decreased as compares with those before treatment in three groups （ P 〈0.05）.The levels of DAO, IL-6, TNF-αand CRP in combination group was lower than that in acupuncture group and enema group （ P 〈0.05）.Conclusion Dachengqi decoction retention enema combined with acupuncture has synergistic action on the recovery of gastrointes -tinal function after abdominal surgery .It can significantly promote abdominal surgery patients recover bowel function , improve the clinical efficacy has important value in clinical application .