参黄汤促肝胆术后气滞血瘀型胃肠功能障碍恢复的临床研究

Shenhuang Decoction on Rehabilitation in Gastrointestinal Dysfunction after Hepatobiliary Operation in Pattern of Qi Stagnation and Blood Stasis

目的:研究参黄汤促进肝胆术后气滞血瘀型胃肠功能障碍恢复的疗效。方法:选取肝胆术后气滞血瘀型胃肠功能障碍的患者64例,随机双盲分为治疗组33例(参黄汤联合常规治疗)和对照组31例(常规治疗),评价两组术后肠鸣音恢复时间、首次排便时间、肠蠕动恢复时间,术后第5 d肝功能指标ALT、AST以及胃动素恢复情况,比较中医症候临床疗效的差异。结果:治疗组术后肠鸣音恢复时间、首次排便时间、肠蠕动恢复时间均比对照组提前(P<0.05);治疗组术后第5 d肝功能指标ALT、AST以及MOT分别为(42.13±12.69)U/L、(43.25±10.48)U/L、(153.13±9.14)pmol/L,对照组为(64.63±20.05)U/L、(75.75±18.16)U/L、(129.00±9.49)pmol/L,治疗组术后第5 d肝功能指标ALT、AST以及MOT恢复情况均优于对照组(P<0.05);治疗组中医症候疗效总有效率87.9%,对照组45.2%(P<0.05),治疗组总有效率明显高于对照组。结论:参黄汤能促进肝胆术后气滞血瘀型胃肠功能障碍的早期恢复,且安全可行。

Objective To study the clinical effect of Shenhuang Decoction on rehabilitation in gastrointesti-nal dysfunction after hepatobiliary operation in pattern of Qi stagnation and blood stasis. Methods A random-ized and double-blind study was conducted on 64 patients after hepatobiliary operation accorded with the inclu-sion criteria, that was divided into a treatment group of 33 patients with conbined treatment of Shenhuang Decoc-tion and western medicine and a control group with 31 patients for conventional western medicine treatment. The recovery time of bowel sounds,first defecation time,recovery time of effective intestinal peristalsis after operation, recovery of ALT,AST,MOT for the fifth days after operation and different clinical effects of TCM symptoms in two groups were evaluated. Results Compared with the control group, the recovery time of bowel sounds, first defecation time, and the recovery time of effective intestinal peristalsis after operation in the treatment group were obviously earlier（P〈0.05）.Indicators of ALT, AST and MOT for fifth days after operation were 42.13±12.69 （U/L）,43.25 ± 10.48（U/L）,153.13 ± 9.14（pmol/L） in the treatment group,and 64.63 ± 20.05（U/L）,75.75 ± 18.16（U/L）,129.00 ± 9.49（pmol/L） in the control group.Recovery of ALT,AST and MOT for fifth days after operation were superior to those in the control group（P〈0.05）.The total effective rate of TCM syndrome in the treatment group and that in the control group were 87.9%, and 45.2% ,with a significant difference between the two groups （P〈0.05）. Conclusion Shenhuang Decoction can promote the rehabilitation of gastrointestinal dysfunction after hepatobiliary operation in syndrome of Qi stagnation and blood stasis, and be used safety.