加味大承气汤保留灌肠治疗实热内结型急性不完全性肠梗阻的效果及对VIP、MTL的影响

Effect of Modified Dachengqi Decoction Retention Enema in the Treatment of Acute Incomplete Intestinal Obstruction of Extremity Heat and Internal Knot Type and Its Influence on VIP and MTL

目的:观察加味大承气汤保留灌肠治疗实热内结型急性不完全性肠梗阻的临床效果及对血清血管活性肠肽(VIP)、胃动素(MTL)的影响。方法:选择2018年12月-2020年5月福建中医药大学附属人民医院住院部收治的100例实热内结型急性不完全性肠梗阻患者为研究对象。按照随机数字表法将其分成两组,每组50例。对照组采用常规西医治疗,治疗组在对照组基础上给予加味大承气汤保留灌肠治疗。比较两组首次排气时间、腹痛缓解时间、腹胀缓解时间、中医证候积分、临床疗效,并用ELISA检测法分别测量两组治疗前后血清VIP、MTL水平。结果:治疗组首次排气时间、腹痛缓解时间、腹胀缓解时间均早于对照组,中医证候积分优于对照组,差异均有统计学意义(P<0.05)。治疗后,两组血清VIP水平均较治疗前明显降低(P<0.01),血清MTL水平均较治疗前明显升高(P<0.01),且治疗组血清VIP、MTL水平均优于对照组,差异有统计学意义(P<0.05)。治疗组治疗总有效率为94%,高于对照组的78%,差异有统计学意义(P<0.05)。结论:加味大承气汤保留灌肠治疗实热内结型急性不完全性肠梗阻,可调节血清VIP、MTL水平,改善患者胃肠动力障碍,提高临床疗效。

Objective:To observe the clinical effect of modified Dachengqi Decoction retention enema in the treatment of acute incomplete intestinal obstruction of extremity heat and internal knot type and its influence on serum vasoactive intestinal peptide (VIP) and motilin (MTL).Method:A total of 100 cases of acute incomplete intestinal obstruction of extremity heat and internal knot type admitted in the inpatient department of the People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from December 2018 to May 2020 were selected as the study subjects.They were divided into the treatment group and the control group according to the random number table method.The control group was treated with conventional western medicine,while the treatment group was treated with modified Dachengqi Decoction retention enema on the basis of the control group.The first exhaust time,abdominal pain relief time,abdominal distension relief time,TCM syndrome score,and clinical efficacy were compared between the two groups.Serum VIP and MTL levels of the two groups before and after treatment were measured by ELISA.Result:The first exhaust time,abdominal pain relief time and abdominal distension relief time in the treatment group were all earlier than those in the control group,and TCM syndrome score was better than that in the control group,the differences were statistically significant (P<0.05).After treatment,serum VIP levels in both groups were significantly lower than those before treatment (P<0.01),serum MTL levels were significantly higher than those before treatment (P<0.01),and serum VIP and MTL levels in the treatment group were better than those in the control group,the differences were statistically significant (P<0.05).The total effective rate of the treatment group was 94%,which was higher than 78% of the control group,and the difference was statistically significant (P<0.05).Conclusion:Modified Dachengqi Decoction retention enema in the treatment of acute incomplete intestinal obstruction of extremity heat and internal knot type can regulate the serum levels of VIP and MTL,improve gastrointestinal motility disorders of patients,and improve the clinical efficacy.