浓煎大承气汤保留灌肠对老年癌性不全肠梗阻的临床研究

Clinical study on the Nongjian Dachengqi decoction retention enema in treatment of senile cancer incomplete intestinal obstruction

目的探讨浓煎大承气汤保留灌肠对老年癌性不全肠梗阻的临床疗效。方法将90例老年癌性不全肠梗阻患者随机分为对照组和观察组,每组45例,在西医对症治疗和护理基础上,对照组给予大承气汤保留灌肠,观察组给予浓煎大承气汤保留灌肠,14 d后比较两组患者的临床疗效、中医症候积分、肠道功能恢复情况、药物保留时间和气液平面消失时间、生活质量和药物不良反应。结果治疗后,观察组的总有效率显著高于对照组(P<0.05),观察组的腹胀、腹痛、恶心呕吐、大便秘结和胸闷等中医症候积分显著低于对照组(P<0.05),观察组的首次排气时间、首次排便时间和肠蠕动恢复时间显著低于对照组(P<0.05),观察组的药物保留时间显著高于对照组,而气液平面消失时间显著低于对照组(P<0.05),观察组的身体、角色、心理、社会和认知等生活质量评分显著高于对照组(P<0.05)。两组患者均未见明显不良反应。结论浓煎大承气汤保留灌肠对老年癌性肠不全梗阻具有较好的临床效果,可降低中医症候积分,恢复肠道功能,提高药物保留时间和患者生活质量,且具有较好的安全性,值得临床推广应用。

Objective To investigate the clinical effect of Nongjian Dachengqi decoction retention enema on senile cancer incomplete intestinal obstruction.Methods Ninety patients with senile cancer incomplete intestinal obstruction were randomly divided into control group and observation group,with 45 cases in each group.On the basis of western medicine symptomatic treatment and nursing,the control group was given Dachengqi decoction retention enema,and the observation group was given Nongijian Chengqi decoction retention d enema.After 14 days,the clinical efficacy,TCM symptom score,intestinal function recovery,drug retention time and gas-liquid plane disappearance time,quality of life and adverse drug reactions were compared between the two groups.Results After treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The TCM scores of abdominal distension,abdominal pain,nausea and vomiting,constipation and chest tightness in the observation group were significantly lower than those in the control group(P<0.05).The first exhaust time,first defecation time and intestinal peristalsis recovery time of the observation group were significantly lower than those in the control group(P<0.05).The drug retention time of the observation group was significantly higher than that of the control group,and the gas-liquid plane disappeared time was significantly lower than that of the control group(P<0.05).The quality of life score such as body,role,psychology,society and cognition of the observation group was significantly higher than that of the control group(P<0.05).No significant adverse drug reactions were observed in either group.Conclusion Nongjian Dachengqi decoction retention enema has a good clinical effect on senile cancer incomplete intestine obstruction,which can reduce TCM syndrome scores,restore intestinal function,improve drug retention time and patient quality of life,and has better safety.It is worthy of clinical application.