莱菔承气汤对胃肠切除术后胃肠功能恢复的影响及机制探索

Effects and mechanism of Laifuchengqi decoction of the recovery of gastrointestinal function after gastrointestinal resection

目的:观察莱菔承气汤灌肠对胃肠切除术后患者胃肠功能恢复的作用,探索其可能的作用机制。方法:将80例胃肠手术患者随机分为莱菔承气汤灌肠组(治疗组)和非灌肠组(对照组)。对照组患者接受常规加速康复外科操作,治疗组患者在此基础上予莱菔承气汤200ml灌肠,qd。观察患者术后胃肠功能恢复时间,同时抽血清监测患者术前1d,术后第1、3、5天血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及瘦素水平。结果:治疗组患者术后排气时间、排便时间、肠鸣音恢复时间及平均住院时间均明显短于对照组;术后第3天开始,治疗组炎症指标CRP、TNF-α及瘦素水平均明显低于对照组(P<0.05)。结论:莱菔承气汤灌肠可改善胃肠切除术后患者全身炎症反应状态,促进胃肠功能恢复,其作用可能与调节血清瘦素水平密切相关。

Objective: To observe the effects and mechanism of Laifuchengqi decoction on gastrointestinal function recovery after gastrointestinal resection.Methods:Eighty patients who underwent gastrointestinal resection were selected and randomly divided into the treatment group and the control group.The patients in the control group received routine enhanced recovery after surgery,while the patients in the treatment group were given an additional 200 ml enema of Laifuchengqi decoction. The recovery time of gastrointestinal function in the 2 groups was closely observed.At the same time,the serum levels of CRP,TNF-α,IL-6 and leptin were detected one day before surgery and 1,3,5 days after surgery. Results: The first anal exhaust time,defecation time,recovery time of bowel sound and average hospitalization days of the treatment group after surgery were all obviously shorter than those of the control group.On the third day after surgery,the levels of CRP,TNF-α and leptin of the treatment group were remarkably lower than those of the control group,with statistical significance ( P <0.05). Conclusion:Laifuchengqi decoction could improve the state of systemic inflammation response and promote recovery of gastrointestinal function after gastrointestinal resection,the mechanism of which might be closely related with the regulation of the serum level of leptin.