大承气汤、奥美拉唑联合西沙必利对胃癌根治术后胃瘫患者血清胃泌素与胃动素水平的影响

Effect of Dachengqi decoction, omeprazole and cisapride in the treatment of gastric cancer radical operation in serum gastrin and motilin

目的 探讨大承气汤、奥美拉唑联合西沙必利对胃癌根治术后胃瘫患者血清胃泌素与胃动素水平的影响。方法 选取2013年5月~2015年7月浙江省人民医院和嘉善县第二人民医院收治的88例胃癌根治术后胃瘫患者,根据不同治疗方法分为对照组和试验组,每组44例,2组均给予常规对症治疗,对照组给予奥美拉唑肠溶胶囊20 mg口服,1次/天,大承气汤水煎剂200 m L/天,分2份,其中1份经胃管注入,另1份保留灌肠,2次/天;试验组在对照组的基础上给予西沙必利片10 mg口服,3次/天。2组患者均治疗21 d。比较2组临床疗效、治疗前后血清胃泌素、血浆胃动、胃液量及不良反应发生情况。结果 试验组总有效率为95.45%,显著高于对照组总有效率77.27%（P〈0.05）;治疗后,2组胃液量显著低于治疗前,且试验组治疗后胃液量显著低于对照组（P〈0.05）;与治疗前相比,2组治疗后血清胃泌素、血浆胃动素水平均显著增高,且试验组血清胃泌素、血浆胃动素水平显著高于对照组（P〈0.05）。2组不良反应发生率比较差异无统计学意义。结论 奥美拉唑、西沙必利联合中药汤剂大承气汤治疗胃癌根治术后胃瘫的临床疗效显著,安全性高。

Objective To evaluate the effect of Dachengqi decoction, omeprazole and cisapride in the treatment of gastric cancer radical operation in serum gastrin and motilin. Methods 88 cases of gastric cancer after radical gastrectomy from May 2013 to July 2015 in our hospital were selected and divided into control group and treatment group with each 44 cases. Patients in both groups were given routine treatment and symptomatic treatment. Control group received omeprazole Enteric-coated capsules 20mg, qd, cisapride tablets lOmg, tid, treatment group received more Dachengqi decoction 200mL, bid, respectively by intragastric injection and retention enema, two times a day, a total of 21 days of treatment. The clinical efficacy, serumgastrin, plasma gastric motility, gastric juice volume and adverse reactions were compared between the two groups. Results The total effective rate in the treatment group was significantly higher than that in control group （P 〈0. 05） ; After treatment, gastric juice volume of two groups was significantly lower than before treatment, the gastric juice volume in the treatment group were significantly lower than control group （P 〈 0. 05 ） ; Compare with pre-treatment, after treatment, the serum gastrin, plasma gastric motility levels of two groups were significantly higher, and the treatment group were significantly higher than the control group （P 〈0. 05）. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Omeprazole, cisapride combined with Dachengqi decoction in the treatment of gastric cancer radical operation was obvious and high safety.