顺气十三味散对子宫全切术后预防肠粘连的临床疗效研究

Clinical Therapeutic Observation of Shun qi shi san wei san for preventive intestinal adhesion after Gynecological Abdominal Operation

目的:观察顺气十三味散对妇科开腹术后预防肠粘连的临床疗效。方法:随机取2016年5月至2017年5月我院收治的妇产科开腹手术患者60例的临床资料。随机分为观察组和对照组,每组为30例患者。两组患者均给予常规禁食、补液、抗感染等治疗。在此基础上,观察组患者给予顺气十三味散,对照组患者常规用药外无其他特殊用药。观察两组患者肠鸣音恢复时间、首次排气时间、排便时间;观察两组患者手术前后胃动素(MTL)水平、胃泌素(GAS)水平变化情况;观察患者不良反应发生情况。结果:观察组患者肠鸣音恢复时间、首次排气时间、排便时间均显著优于对照组(20. 21±1.56vs31. 18±4. 38) h、(34. 32±9. 13vs49. 13±8. 72) h、(51. 94±6. 59vs65. 82±5. 67) h,差异有统计学意义(P <0. 05)。手术后24h、48h和手术后72h,观察组患者MTL水平显著高于对照组,(327. 67±5. 83vs271. 47±11. 28) pg/m L,(348. 83±5.23vs265. 06±12. 38) pg/m L,(341. 86±7. 33vs324. 66±8. 56) pg/m L差异有统计学意义(P <0. 05;手术前24h观察组和对照组患者MTL水平,无统计学意义(P>0. 05)。结论:顺气十三味散对促进妇科开腹手术后胃肠功能恢复能够改善患者肠鸣音恢复时间、首次排气时间、排便时间,利于MTL水平的恢复,而且不良反应发生较少,值得临床推广。

Objective To observe the clinical efficacy of Shun qi shi san wei san in treating intestinal adhesion after gynecological abdominal operation. Method Totally 120 eligible patients undergone gynecological operation were randomized into observation group of 30 cases and control group of 30 cases.Two groups of pations were given conventional fasting、gastrointestinal decompression、flud infusion and anti-infection.On this basis,observation group given by Shun qi shi san wei san and control group given by physiological saline.After a treatment course, the symptom scores, restored time of bowel sounds, anal exhaust time and motilin （MTL） contents were observed and compared, and the clinical efficacies were compared between the two groups. Result The symptom scores of the two groups were significantly changed after the intervention （ P 〈0.05）. After the treatment, the symptom score of observation group was significantly different from that of control group （ P 〈0.05）. The restored time of bowel sounds and anal exhaust time in bservation group were significantly different from that of control group（ P 〈0.05）. The MTL contents of the two groups were significantly changed after the intervention （ P 〈0.05）. The MTL contents of observation group were markedly different from that of control group （ P 〈0.05）. Conclusion Shun qi shi san wei san is effective in treatinggastrointestinal dysfunction after gynecological abdominal operation.