厚朴排气合剂和四磨汤在胃癌术后肠道功能恢复中的疗效对比

Comparison of Houpupaiqi mixture and Simo decoction in the recovery of intestinal function after gastric cancer surgery

目的比较厚朴排气合剂和四磨汤对于胃癌术后早期肠道功能恢复及不良反应的差异。方法选取133例行胃癌切除术患者进行随机对照研究,将其随机分为两组,其中观察组在术后6h、10h各鼻饲50ml厚朴排气合剂,对照组术后12h后起鼻饲四磨汤口服液,每次20ml,每天3次,至少给药6次。观察比较两组患者术后排气排便时间、腹胀及恶心呕吐等不良反应的发生。主要研究终点:术后首次排气及排便时间。次要研究终点:术后不良反应,术后住院天数。结果18例患者因术中探查发现腹腔转移行姑息性手术或放弃手术,或因术中改变手术方式行全胃切除退出本研究。最终共纳入115例患者,其中观察组59例,对照组56例;观察组的术后首次排气、排便时间均显著短于对照组(P<0.05);观察组术后住院时间短于对照组(P<0.05)。观察组腹胀的发生率明显低于对照组(P<0.05),两组恶心、呕吐、腹泻的不良反应发生率比较差异无统计学意义。结论与四磨汤相比,厚朴排气合剂更利于胃癌术后肠道功能恢复,促进术后康复,缩短住院时间。

Objective To compare the recovery of gastrointestinal function and adverse reaction in gastric cancer patients with either Houpupaiqi mixture or Simo decoction after surgery. Methods 133 patients with gastric cancer resection were enrolled in a randomized controlled trial and randomly divided into two groups. The observation group received 50 ml of Houpu venting mixture at 6 h and 10 h after operation. The control group received nasal feeding of Simo decoction Liquid 12 h after the operation, 20 ml each time, 3 times a day, at least 6 times. The adverse reactions such as postoperative exhaustion time, abdominal distension and nausea and vomiting were observed and compared between the two groups. Primary study end points: the times of first exhaust, first defecation. Secondary end points of study: adverse reactions, postoperative hospital stay. Results 18 patients withdrew from this study due to intraoperative exploration of abdominal metastases for palliative surgery or abandonment of surgery, or total gastrectomy due to intraoperative changes in surgical procedures. A total of 115 patients were evaluated (study group 59 patients, control group 56 patients). The first exhaust and defecation time of the observation group were significantly shorter than the control group (P<0.05). The postoperative hospital stay was shorter in the observation group than the control group (P<0.05). The incidence of abdominal distension in the observation group was significantly lower than that in the control group (P<0.05), there was no significant difference in the incidence of adverse reactions between nausea, vomiting and diarrhea. Conclusion The use of Houpupaiqi mixture in postoperative patients resulted in comprehensive enhancement of gastrointestinal function recovery with less adverse reactions, promoting postoperative recovery and shortening hospital stay.