复方大承气汤灌肠联合针刺足三里穴对急性弥漫性腹膜炎术后疗效的影响

Effect of acupuncture at Zusanli acupoint combined with Dachengqi decoction retention-enema on acute diffuse peritonitis after surgery

目的评价复方大承气汤灌肠联合针刺足三里穴对急性弥漫性腹膜炎术后疗效的影响。方法将90例急性弥漫性腹膜炎患者随机分成治疗组44例和对照组46例,2组患者术后均给予抗感染、支持等对症治疗,治疗组在此常规治疗基础上用复方大承气汤保留灌肠并联合针刺足三里穴。观察2组患者肠鸣音恢复时间,首次肛门排气、排便时间及术后并发症发生情况,术后第1,3,5天测定白细胞计数、内毒素及血TNF-α含量,比较2组变化情况。结果治疗组白细胞计数、内毒素及血TNF-α下降幅度明显大于对照组(P均<0.05);肠鸣音恢复时间、首次肛门排气、排便时间明显短于对照组(P均<0.05)。治疗组术后并发症发生率明显低于对照组(P<0.05)。结论急性弥漫性腹膜炎术后给予复方大承气汤灌肠联合针刺足三里穴能促进患者胃肠功能恢复,减少并发症的发生。

Objective It is to observe the curative effect of acupuncture at Zusanli acupoint combined with Dachengqi de -coction on postoperative acute diffuse peritonitis .Methods 90 cases of acute diffuse peritonitis patients were randomly divided into two groups,the treatment group （n=44） and the control group（n=46） .The patients were given anti-infection and symp-tomatic treatment , support after operation .The treatment group was treated with acupuncture at Zusanli acupoint combined with Dachengqi decoction retention-enema together with the basic therapy .The recovery of borborygmus , anal exhaust time , defecation time,postoperative complications and the count of white blood cell , endotoxin, TNF-αon day 1,3,5 were ob-served in both groups ,and the changes were compared between the two groups .Results The decline range of count of white blood cell,endotoxin, TNF-αof the treatment group were sharply more obviously than those of the control group （P〈0 .05）. The recovery of borborygmus , anal exhaust time , defecation time of the treatment group were significantly shorter than those of the control group （ P〈0.05）.Postoperative complications rate of treatment group was obviously lower than that of control group.Conclusion The treatment with acupuncture at Zusanli acupoint combined with Dachengqi decoction retention -enema can promote the recovery of gastrointestinal function and reduce complications in the patients with acute diffuse peritonitis after operation.