中药五倍子乌梅汤保留灌肠预防内镜下肠息肉摘除术后复发的效果研究

Effect of retention enema with Wubei Zi and Wumei Decoction of Chinese medicine in preventing recurrence of intestinal polyps after endoscopic polypectomy

目的探讨肠息肉术后中药五倍子乌梅汤保留灌肠对肠息肉术后复发的预防效果。方法采用随机数表法将接受内镜下肠息肉摘除术的84例患者分为对照组和观察组,各42例。2组术后均实施外科常规护理,对照组于术后第8天口服马来酸曲美布汀胶囊治疗,观察组由中药房统一煎制五倍子乌梅汤给予中药保留灌肠治疗,2组均持续治疗4周并随访12个月。观察2组治疗前后腹痛、腹胀、大便泄泻等主要症状积分变化并评估中医证候疗效,比较2组术后6、12个月的复发情况。结果治疗后,2组腹痛、腹胀、大便泄泻积分均低于治疗前,且观察组积分低于对照组,差异有统计学意义(P<0.05);观察组中医证候的治疗总有效率97.62%高于对照组80.95%,差异有统计学意义(P<0.05);随访6个月时,2组肠息肉复发率比较,差异无统计学意义(P>0.05),随访12个月时,观察组复发率7.14%低于对照组23.81%,差异有统计学意义(P<0.05)。结论中药五倍子乌梅汤保留灌肠能有效改善肠息肉患者术后临床症状,降低术后复发风险。

Objective To investigate effect of Wubei Zi and Wumei Decoction of Chinese medicine in preventing recurrence of intestinal polyps after endoscopic polypectomy.Methods A total of 84 patients who underwent endoscopic polypectomy in our hospital were randomly divided into control group and observation group,with 42 cases in each group.Both groups were given routine surgical nursing after operation.The control group was additionally treated with Trimebutine Maleate Capsules for oral administration at 8 d after operation,while the observation group was treated with Wubei Zi and Wumei Decoction provided by TCM Pharmacy Department for retention enema.All patients were treated for 4 weeks and followed up for 12 months.The changes of main symptoms scores such as abdominal pain,abdominal distension and diarrhea were observed before and after treatment,and the curative effect of TCM syndromes was evaluated.The recurrence of the two groups was observed at 6 and 12 months after operation.Results After treatment,the scores of abdominal pain,abdominal distension and diarrhea in the two groups was significantly lower than those before treatment(P<0.05).The total effective rate of TCM syndromes in the observation group was higher than that in the control group(97.62%vs.80.95%,P<0.05).There was no significant difference in the recurrence rate of intestinal polyps between the two groups at 6 months of follow-up(P>0.05).The recurrence rate of the observation group at 12 months of follow-up was lower than that of the control group(7.14%vs.23.81%,P<0.05).Conclusion Wubei Zi and Wumei Decoction can effectively improve the clinical symptoms and reduce the recurrence risk of intestinal polyps for retention enema.