肠舒汤保留灌肠治疗旷置性结肠炎的临床效果

CLINICAL EFFECT OF RETENTION ENEMA WITH CHANGSHU DECOCTION IN TREATMENT OF DIVERSION COLITIS

目的探讨预防性末端回肠造口术后应用肠舒汤保留灌肠治疗旷置性结肠炎的临床效果。方法2015年5月—2017年10月,选择在我科行预防性末端回肠造口术的病人56例,随机分为2组。行末端回肠造口闭合术前,对照组23例病人以温生理盐水保留灌肠,观察组33例病人以肠舒汤保留灌肠,每天1次,治疗1周。分别于保留灌肠治疗前后,用电子结肠镜检查旷置结肠的黏膜改变;比较两组病人末端回肠造口闭合术后肠道功能恢复情况。结果保留灌肠治疗1周后,观察组病人红斑肿胀、滤泡增生及溃疡糜烂等结肠炎症表现较对照组明显改善,差异有显著性(χ2=5.63~31.48,P<0.05)。观察组病人较对照组术后进食时间、术后肛门排气排便时间及住院时间明显缩短(t=7.19~12.49,P<0.05),肠梗阻的发生率明显降低(χ2=4.65,P<0.05)。结论肠舒汤保留灌肠治疗旷置性结肠炎,可以促进肠黏膜的损伤修复和溃疡组织的愈合,促进末端回肠造口闭合术后病人肠道功能的恢复,值得在临床中推广应用。

Objective To investigate the clinical effect of retention enema with Changshu Decoction in the treatment of diversion colitis after preventive terminal ileostomy.Methods A total of 56 patients who underwent preventive terminal ileostomy in our department from May 2015 to October 2017 were enrolled and randomly divided into control group with 23 patients and observation group with 33 patients.After terminal ileostomy closure,the patients in the control group were given retention enema with warm normal saline,and those in the observation group were given retention enema with Changshu Decoction,once a day for 1 week.An electronic colonoscope was used to observe colonic mucosa before and after retention enema,and the two groups were compared in terms of the recovery of gastrointestinal function after ileostomy closure.Results Compared with the control group after 1 week of retention enema,the observation group had significant improvements in the symptoms of colitis including mucosal erythema and swelling,follicular hyperplasia,and mucosal erosion and ulcers(χ2=5.63-31.48,P<0.05).Compared with the control group,the observation group had significantly shorter time to postoperative first eating,time to postoperative first flatus,time to postoperative first defecation,and length of hospital stay(t=7.19-12.49,P<0.05),as well as a significantly lower incidence rate of ileus(χ2=4.65,P<0.05).Conclusion In the treatment of diversion colitis,retention enema with Changshu Decoction can promote the repair of intestinal mucosal injury,the healing of ulcer tissue,and the recovery of gastrointestinal function after terminal ileostomy closure,and thus it holds promise for clinical application.