大承气汤辅助治疗小儿腹部术后胃肠功能障碍50例临床观察

Clinical observation on Dachengqi Tang(大承气汤)in adjuvant treatment of 50 cases of gastrointestinal dysfunction after abdominal surgery in children

目的观察大承气汤辅助治疗小儿腹部术后胃肠功能障碍的临床疗效。方法选取2016年1月至2018年12月在余姚市第四人民医院中西医结合外科住院部住院的100例腹部术后胃肠功能障碍患儿作为研究对象,按照随机数字表法分为治疗组和对照组,各50例。对照组术后给予吗丁啉口服治疗,治疗组在对照组治疗方法的基础上予中药大承气汤保留灌肠或口服治疗,2组均连续治疗7 d后,比较胃肠道功能恢复情况、临床疗效以及治疗前后血清炎症因子水平的变化情况。结果治疗组总有效率为94.0%(47/50),对照组为76.0%(38/50),2组比较,差异有统计学意义(P<0.05)。治疗后,治疗组肛门首次排气时间、首次排便时间、肠鸣音恢复时间、恢复正常饮食时间均明显短于对照组,2组比较,差异有统计学意义(P<0.05)。治疗前,2组血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死子-α(TNF-α)水平比较,差异无统计学意义(P>0.05),具有可比性。治疗后2组血清CRP、IL-6、TNF-α水平均较同组治疗前显著下降(P<0.05),且治疗组下降更显著(P<0.05)。结论大承气汤辅助治疗小儿腹部术后胃肠功能障碍,能有效促进患儿胃肠功能恢复,抑制炎症反应,疗效显著,值得临床推广应用。

Objective To observe the clinical efficacy of Dachengqi Tang(大承气汤)in adjuvant treatment of gastrointestinal dysfunction after abdominal surgery in children.Methods Totally 100 children with gastrointestinal dysfunction hospitalized in inpatient department of integrated Chinese and Western medicine surgery in the Fourth People’s Hospital of Yuyao from January 2016 to December 2018 were chosen as research objects and divided into treatment group and control group according to random number table method,with 50 cases in each.The control group was given oral motilium after surgery,on this basis,the treatment group was given retention enema or oral administration of Dachengqi Tang.After 7 consecutive days of treatment,the recovery of gastrointestinal function,clinical efficacy and the changes of serum levels of inflammatory factors before and after treatment of the 2 groups were compared.Results The total effective rate was 94.0%(47/50)in the treatment group and 76.0%(38/50)in the control group,and the difference between the 2 groups was statistically significant(P<0.05).After treatment,the time of the anal first exhaust,the time of the first defecation,recovery time of bowel sound,and the time of returning to normal diet in the treatment group were significantly shorter than those in the control group,and the difference between the two groups was statistically significant(P<0.05).Before treatment,the difference was not statistically significant in the serum levels of C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)between the 2 groups(P>0.05),and they were comparable.After treatment,the serum levels of CRP,IL-6 and TNF-αin the two groups decreased significantly than those in the same group before treatment(P<0.05),moreover,the treatment group decreased more significantly(P<0.05).Conclusion It can effectively promote the recovery of gastrointestinal function and inhibit the inflammatory reaction with marked efficacy to use Dachengqi Tang in adjuvant treatment of gastrointestinal dysfunction after abdominal surgery in children,which is worthy of promotion and application.