子午流注法中药灌肠对肝胆湿热型急性胆囊炎腹腔镜术后胃肠功能的影响

Effect of Traditional Chinese Medicine Enema Guided by Midnight-noon Ebb-flow on Gastrointestinal Function after Laparoscopic Cholecystectomy for Acute Cholecystitis with Dampness-heat of Liver and Gallbladder

目的观察子午流注法中药灌肠对肝胆湿热型急性胆囊炎腹腔镜术(LC)后胃肠功能的影响。方法将60例LC术后病例随机分为对照组、治疗1组、治疗2组,各20例。对照组术后常规治疗;治疗1组在对照组基础上,选择非卯时予中药灌肠;治疗2组在对照组基础上,选择卯时(5:00—7:00)予中药灌肠。比较3组术后胃肠功能恢复情况及手术前后C反应蛋白(CRP)、降钙素原(PCT)水平。结果与对照组相比,治疗1组和治疗2组在肠鸣音恢复时间、首次排气时间、首次排便时间方面都相对较短,差异均具有统计学意义(P<0.05)。与治疗1组相比,治疗2组在肠鸣音恢复时间、首次排气时间、首次排便时间方面也相对较短,差异均具有统计学意义(P<0.05)。术后第1、3、5天,治疗2组、治疗1组患者血清CRP和PCT水平均低于对照组,差异均有统计学意义(P<0.05);术后第1、3、5天,治疗2组患者血清CRP和PCT水平均低于治疗1组,差异均有统计学意义(P<0.05)。结论运用子午流注法的卯时中药灌肠可促进LC术后胃肠功能恢复,有效抑制术后炎症水平,临床疗效良好。

Objective To observe the effect of TCM enema guided by midnight-noon ebb-flow on gastrointestinal function after laparoscopic cholecystectomy(LC)for acute cholecystitis with damp-heat of liver and gallbladder.Methods 60 cases of acute cholecystitis with damp-heat of liver and gallbladder after laparoscopic cholecystectomy were randomly divided into control group,treatment group 1 and treatment group 2,with 20 cases in each.The control group was given routine treatment of Western medicine.The treatment group 1 received TCM enema on the basis of the control group,and choose the time for the non-mao time.The treatment group 2 received TCM enema at Mao time(5:00-7:00)on the basis of the control group.The recovery of gastrointestinal function after operation and the levels of C-reactive protein(CRP)and procalcitonin(PCT)before and after operation were compared among the 3 groups.Results The recovery of gastrointestinal function in 3 groups was compared.The levels of C-reactive protein and Procalcitonin were measured before and after operation in 3 groups.Compared with the control group,the recovery time of bowel sounds,the time of first exhaust and the time of first defecation were shorter in the treatment group 1 and the treatment group 2(P<0.05).Compared with the treatment group 1,the time of recovery of bowel sounds,the time of first exhaust and the time of first defecation in the treatment group 2 were also relatively short,the difference was statistically significant(P<0.05).At the first,third and fifth day after operation,the levels of CRP and PCT in the patients of treatment group 2 and treatment group 1 were significantly lower than those of control group(P<0.05).At the first,third and fifth days after operation,the levels of CRP and PCT in the treatment group 2 were lower than that in the treatment group 1(P<0.05).Conclusion The traditional Chinese medicine enema with midnight-noon ebb-flow method can promote the recovery of gastrointestinal function and restrain the inflammatory level after laparoscopic cholecystectomy for acute cholecystitis with dampness-heat of liver and gallbladder.