厚朴三物汤灌肠治疗胸腰段脊柱骨折后顽固性腹胀120例临床观察

Clinical observation of Houposanwu Decoction for enema in the treatment of intractable abdominal distension due to thoracolumbar spine fracture in 120 cases

目的探讨厚朴三物汤灌肠治疗胸腰段骨折后顽固性腹胀的临床效果。方法经我院医学伦理委员会批准,采取前瞻性、随机、双盲对照研究,选取2015年3月~2016年3月在我院住院治疗的胸腰段骨折后顽固性腹胀患者120例作为研究对象。随机分为两组,对照组60例,给予常规新斯的明臀部肌内注射治疗;治疗组60例,给予厚朴三物汤灌肠治疗。观察两组患者给药后腹胀缓解情况、排气时间、排便时间等指标。结果对照组显效率为55.00%,总有效率为83.33%;治疗组显效率为73.33%,总有效率为95.00%,差异有统计学意义(P<0.05);治疗后对照组排气时间为(0.87±0.18)h,治疗组排气时间为(0.39±0.14)h,差异有统计学意义(P<0.05);治疗后对照组排便时间为(2.23±0.32)h,治疗组排便时间为(1.21±0.33)h,差异有统计学意义(P<0.05)。结论厚朴三物汤灌肠可明显缓解胸腰段骨折后顽固性腹胀患者的腹胀不适症状,缩短腹胀时间,具有简单易行,疗效可靠等特点,特别适合基层医院推广应用。

Objective To explore the clinical effect of Houposanwu Decoction for enema in the treatment of intractable abdominal distension due to thoracolumbar spine fracture.Methods After being approved by Medical Ethics Committee of our hospital,a prospective,double-blind,randomized,controlled study was conducted in 120 patients with refractory abdominal distension after thoracolumbar fracture in our hospital from March 2015 to March 2016.They were selected as research objects and evenly divided into two groups in random.In control group（n=60）,patients were treated by regular intramuscular injection of Neostigmine,while in treatment group（n=60）,Houposanwu Decoction for enema was adopted.The abdominal distension relief after medication,exhaust time,and defecation time in the two groups were observed.Results The marked improvement rate and total effective rate in the control group was 55.00% and 83.33%,and in the treatment group,they were 73.33% and 95.00% respectively,with statistical difference（P〈0.05）.After therapy,the exhaust time was（0.87±0.18）h in the control group,while（0.39±0.14）h in the treatment group,with statisticant difference（P〈0.05）.The defecation time in the control group and treatment group was（2.23±0.32）h and（1.21±0.33）h, with statisticant difference（P〈0.05）.Conclusion Houposanwu Decoction for enema can greatly alleviate the symptoms of abdominal distension in patients with intractable abdominal distension due to thoracolumbar spine fracture and shorten the time of abdominal distension at advantages of being simple and easy to perform,and reliable on effect,which is especially suitable for promotion in grass-roots hospitals.