温通法对肠结-阳虚寒凝证疗效及肿瘤坏死因子-α和白细胞介素-6的影响

Effect of Wentong Method on the Curative Effect of Intestinal Node-Yang Deficiency and Cold Coagulation and the Effects of TNF-αand Interleukin-6

目的:观察温通法对肠结-阳虚寒凝证的疗效及对肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6的影响。方法:选取阳虚寒凝证肠梗阻患者75例,随机分为对照组、治疗A组、治疗B组各25例。对照组采用常规治疗;治疗A组采用温通散外敷神阙穴并常规治疗;治疗B组采用温通散外敷神阙穴并中药灌肠加常规治疗。比较3组临床指标及TNF-α、IL-6水平变化。结果:治疗组腹痛评分[A组(2.80±0.70)、B组(2.16±0.74)]、腹胀评分[A组(2.52±0.58)、B组(2.08±0.64)]、首次排气时间[A组(3.96±0.84)天、B组(3.20±0.57)天]、首次排便时间[A组(5.20±0.70)天、B组(4.40±0.73)天]、肠鸣音恢复时间[A组(2.12±0.60)天、B组(1.76±0.66)天]较对照组腹痛(3.32±0.94)、腹胀(2.96±0.84)、首次排气时间(4.92±0.90)天、首次排便时间(6.04±0.97)天、肠鸣音恢复时间(2.64±0.63)天,均有所改善(P<0.05)。治疗组中医证候疗效(A组80%、B组92%)及临床症状疗效(A组80%、B组92%)较对照组中医证候疗效(64%)及临床症状疗效(60%)均有所提高(P<0.05)。治疗组TNF-α水平[A组(41.62±1.55)pg/mL、B组(31.51±1.40)pg/mL]、IL-6[A组(45.93±3.18)ng/mL、B组(31.54±2.49)ng/mL]均低于对照组TNF-α(54.41±1.35)pg/mL、IL-6(71.89±2.94)ng/mL,且治疗B组在临床指标、实验室指标、中医证候疗效及临床症状疗效方面较治疗A组均有所改善(P<0.05)。结论:温通法治疗阳虚寒凝证肠梗阻疗效确切,能够改善患者临床症状、促进胃肠功能的恢复,并降低TNF-α、IL-6水平。

Objective To observe the effect of Wentong method on the efficacy of intestinal node-yang deficiency and cold coagulation syndrome and the effects of TNF-αandinterleukin-6.Methods Seventy-fivepatients with intestinal node-yang deficiency and cold coagulation syndrome were selected and divided into control group,treatment group A and treatment group B,which 25 cases in each group.Control group:conventional treatment;treatment group A:Wentongsan external application Shenqueacupoint+conventional treatment;treatment group B:Wentongsan external application Shenqueacupoint+traditional Chinese medicine enema+conventional treatment.Compare the clinical indicators and changes of TNF-αand interleukin-6 levels in the above threegroups.Results Abdominal pain(groupA:2.80±0.70,group B:2.16±0.74),abdominal distension(groupA:2.52±0.58,group B:2.08±0.64),first exhausttime(groupA:3.96±0.84,groupB:3.20±0.57),first defecation time(groupA:5.20±0.70,group B:4.40±0.73),recovery time of bowel sounds(groupA:2.12±0.60,group B:1.76±0.66).The treatment group were improved than those in the control group(P<0.05):abdominal pain(3.32±0.94),abdominal distension(2.96±0.84),first exhaust time(4.92±0.90),first defecationtime(6.04±0.97),recovery time of bowel sounds(2.64±0.63).The TCM syndrome(groupA:80%,group B:92%)and clinical efficacy(groupA:80%,group B:92%).The treatment group were improved than those in the control group(P<0.05):TCM syndrome(64%)and clinicalsymptomsefficacy(60%).The TNF-α[groupA:(41.62±1.55)pg/mL,group B:(31.51±1.40)pg/mL],interleukin-6[groupA:(45.93±3.18)pg/mL,group B:(31.54±2.49)ng/mL]in the treatment group was lower than those in the control:TNF-α[(54.41±1.35)pg/mL],interleukin-6[(71.89±2.94)ng/mL].The clinical parameters,laboratory parameters,TCM syndrome and clinical effect in group B was higher than those in group A(P<0.05).Conclusion Wentong method is effective in treating intestinal node-yang deficiency and cold coagulation.It canimprove clinical symptoms,promote the recovery of gastrointestinal function and reduce the levels of TNF-αand interleukin-6.