气汤化裁穴位贴敷对术后早期炎性肠梗阻患者肠黏膜功能、微炎性反应状态的影响

Effects of Intestinal Mucosa Function and Micro Inflammatory State for Treating Early Postoperative Inflammatory Ileus Patients with Acupoint Sticking of Modified Chengqi Decoction

目的:探讨承气汤化裁穴位贴敷对术后早期炎性肠梗阻患者的临床效果,探讨其对患者肠黏膜功能、微炎性反应状态的影响。方法:选取2016年1月至2018年1月秦皇岛市中医医院收治的术后早期炎性肠梗阻患者112例作为研究对象,按照随机数字表法分为对照组和观察组,每组56例。2组患者均给予术后常规处理,对照组患者在常规处理的基础上加用生长抑素持续静脉注射24 h,观察组则在对照组的基础上加用承气汤化裁穴位贴敷治疗,连续治疗1周为1个疗程。统计2组患者治疗的临床效果,比较治疗前后2组患者症状消失时间、胃肠功能恢复时间,检测治疗前后肠屏障功能指标血清D-乳酸、内毒素(Endotoxin,ET)、二胺氧化酶(Diamine Oxidase,DAO)水平及血清炎性反应因子肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive Protein,CRP)、降钙素原(Procalcitonin,PCT)水平的变化。结果:与对照组75.0%的有效率比较,观察组有效率高达91.1%(P<0.05);观察组患者主要临床症状消失时间、胃肠功能恢复时间均短于对照组(P<0.05);2组患者治疗后的肠屏障功能指标D-乳酸、ET、DAO水平及血清微炎性反应状态指标TNF-α、IL-6、CRP、PCT水平均低于治疗前(P<0.05),以观察组更低(P<0.05)。结论:承气汤化裁穴位贴敷利于促进术后早期炎性肠梗阻患者症状的消退及胃肠功能恢复,改善肠黏膜屏障功能,减少肠道炎性反应,值得临床推广运用。

Objective:To investigate the clinical effect of treating early postoperative inflammatory ileus patients with acupoint sticking of modified Chengqi Decoction,and explore the influence of intestinal mucosa function and micro inflammatory state.Methods:A total of 112 cases of early postoperative inflammatory ileus treated in Qinhuangdao Traditional Chinese Medicine Hospital were selected as study subjects,and randomly divided into a control group(n=56 cases)and an observation group(n=56 cases).Patients in both groups were treated with postoperative routine treatment,and patients in the control group were treated with somatostatin continuous intravenous injection for 24 hours on the basis of routine treatment,while patients in the observation group were treated with modified Chengqi Decoction acupoint application on the basis of the control group,with continuous treatment for 1 week as the course of treatment.The clinical effect of 2 groups of treatment was calculated.The symptoms disappear time,gastrointestinal function recovery time of the 2 groups were compared.The intestinal barrier function indexes before and after treatment were detected,including the serum D-lactic acid,endotoxin(ET),Diamine oxidase(DAO)level and the serum levels of inflammatory cytokines tumor necrosis factor-α(TNF-α),Interleukin 6(IL-6),c-reactive protein(CRP)and procalcitonin(PCT)levels.Results:Compared with 75.0%of the control group,the efficiency of the observation group was as high as 91.1%(P<0.05).The main clinical symptoms and gastrointestinal function recovery time of the observation group were shorter than those of the control group(P<0.05).After treatment,the levels of d-lactic acid,ET,DAO and the serum micro inflammatory state indicators TNF-α,IL-6,CRP and PCT were all decreased in the 2 groups than before treatment(P<0.05),and the observation group was even lower(P<0.05).Conclusion:The acupoint application of modified Chengqi Decoction is conducive to promoting the symptom regression and gastrointestinal function recovery of early postoperative inflammatory ileus patients,improving the intestinal mucosal barrier function and reducing intestinal inflammatory response,which is worthy of clinical application.