参黄膏敷神阙穴治疗术后气滞血瘀型胃肠功能不全的临床观察

Effect of Shenhuang Ointment in Promoting the Rehabilitation of Postoperative Gastrointestinal Dysfunction Patients of Qi Stagnation Blood Stasis Syndromee: a Clinical Observation

目的观察中药复方参黄膏敷神阙穴治疗术后气滞血瘀型胃肠功能不全的疗效及安全性。方法采用前瞻性、多中心、随机、双盲、安慰剂平行对照实验设计方案,将220例气滞血瘀型胃肠功能不全患者,按中央数字表法随机分成参黄膏组(110例)及安慰剂组(110例),两组患者术后分别敷神阙穴治疗5天,观察肛门排气、排便情况,肠蠕动恢复情况,中医证候积分,血清胃动素、生长抑素等疗效指标。结果与安慰剂组比较,参黄膏组术后肛门排气、排便及术后第3天肠蠕动恢复情况均有改善(P<0.05);与安慰剂比较,参黄膏组术后第2、3、4天中医证候评分降低(P<0.01,P<0.05),两组中医证候总有效率(分别为95.3%、91.8%)比较,参黄膏组优于安慰剂组(P<0.05);与安慰剂组比较,参黄膏组术后第5天血清生长抑素(somatostatin,SS)降低,胃动素(motilin,MOT)升高(P<0.05)。结论参黄膏敷神阙穴可缩短气滞血瘀型胃肠功能不全患者肛门排气排便时间,改善患者临床症状,耐受性良好。

Objective To observe the effect and safety of plastering Chinese Compound Shenhuang Ointment （CSO） at Shenque （RN8） in promoting the rehabilitation of postoperative gastrointestinal dysfunction patients of qi stagnation blood stasJs syndrome （QSBSS）. Methods A prospective, multi-centered, randomized, double-blinded, controlled trial was conducted in 220 postoperative gastrointestinal dysfunction patients of QSBSS. They were randomly assigned to two groups, the CSO group （110 cases） and the placebo group （110 cases）. CSO was plastered at Shenque （RN8） for 5 days after operation. The time of exhaustion, defecation, the recovery of intestinal peristalsis, integrals of TCM syndrome, and serum levels of motilin （MOT）and somatostatJn （SS） were observed. Results Compared with the placebo group, the condition of exhaustion and defecation, the recovery of intestinal peristalsis on the 3rd day after operation was all improved （P 〈0.05）.The integrals of TCM syndrome at day 2, 3, and 4 were more significantly lowered in the CSO group than in the placebo group （P 〈0. 01, P 〈0.05）. The total effective rate of TCM syndrome was 95. 3% in the CSO group, bet- ter than that in the placebo group （91.8%, P 〈0.05）. Compared with the placebo group, the serum MOT level increased and the serum SS level decreased at day 5 after operation in the CSO group （P 〈0.05）. Conclusions The plastering of CSO at Shenque （RN8） could advance the time of exhaustion and defecation, and improve patients＇ clinical symptoms. And patients could tolerate well.