健脾通气方对剖宫产术后产妇胃肠功能恢复及乳汁分泌的影响

Effect of Jianpi Tongqi Formula on gastrointestinal function recovery and milk secretion in women with cesarean section

目的观察健脾通气方对剖宫产术后产妇胃肠功能恢复及乳汁分泌的影响。方法将123例剖宫产术后产妇按照随机数字表法分2组,对照组61例予剖宫产术后常规治疗,治疗组62例在对照组基础上联合健脾通气方治疗。2组均治疗4 d,比较2组产妇术后第1、4 d中医证候(包括面色、腹痛、腹胀及恶心呕吐)评分变化情况,比较2组产妇术后肠鸣音恢复时间、首次排气时间及首次排便时间情况,比较2组产妇术后第1、4天血清胃动素(MTL)、胃泌素(GAS)、血管活性肠肽(VIP)、泌乳素(PRL)水平变化情况,比较2组产妇术后第4天乳汁满足新生儿喂食情况及全部满足平均时间情况。结果2组术后第4天中医证候面色、腹痛、腹胀、恶心呕吐评分及总分与本组术后第1天比较均降低(P<0.05),且治疗组术后第4天中医证候面色、腹痛、腹胀评分及总分均低于对照组(P<0.05)。治疗组组术后肠鸣音恢复时间、首次排气时间、首次排便时间均短于对照组(P<0.05)。与本组术后第1天比较,2组术后第4天MTL、GAS、PRL水平均升高(P<0.05),VIP水平均降低(P<0.05),且治疗组术后第4天各指标改善均优于对照组(P<0.05)。治疗组术后第4天乳汁满足率83.87%(52/62),全部满足平均时间(2.78±0.72)d,对照组分别为62.30%(38/61)、(4.04±0.85)d,治疗组术后第4天乳汁满足率高于对照组(P<0.05),全部满足平均时间短于对照组(P<0.05)。结论健脾通气方可明显改善剖宫产术后产妇中医证候,促进胃肠功能恢复,缩短肠鸣音恢复时间、首次排气时间及首次排便时间,促进乳汁分泌,缩短乳汁满足新生儿需要时间,其作用机制可能与调节MTL、GAS、VIP及PRL水平有关。

Objective To observe the effect of Jianpi Tongqi Formula on gastrointestinal function recovery and milk secretion in women with cesarean section(CS).Methods Totally 123 women with CS were randomly divided into two groups,after cesarean section,61 cases in control group received routine treatment,and 62 cases in treatment group additionally received Jianpi Tongqi Formula on the basis of control group.After 4 days treatment,the aim was to compare TCM symptom(facies,abdominal pain,abdominal distension,nausea and vomiting)scores on the 1st,4th day;the time to first bowel sound,first passage of flatus,first defecation;serum motilin(MTL),gastrin(GAS)and vasoactive intestinal peptide(VIP),prolactin(PRL)on the 1st,4th day;satisfaction with breastfeeding on the 4th day,and average time to meet all satisfaction.Results After treatment,TCM symptom scores on the 4th day in groups were notably decreased than that on 1st day(P<0.05);scores of facies,abdominal pain and abdominal distension on the 4th day were evidently lower in treatment group than in control group(P<0.05).The time to first bowel sound,first passage of flatus,first defecation were obviously shorter in comparison with control group(P<0.05).MTL,GAS and PRL on the 4th day in groups were remarkably increased than those on the 1st day(P<0.05),while VIP was decreased(P<0.05),improvement of which in treatment group were significantly better(P<0.05).The satisfaction with breastfeedin on the 4th day was 83.87%(52/62)and 62.30%(38/61)for treatment groups and control group,respectively,the satisfaction with breastfeeding was higher in treatment group than control group(P<0.05);the average time to meet all satisfaction in treatment group was shorter than that in control group[(2.78±0.72)d vs(4.04±0.85)d,(P<0.05),respectively].Conclusion For women with CS,Jianpi Tongqi Formula can significantly improve TCM symptom,promote gastrointestinal function recovery,shorten the time to first bowel sound,first passage of flatus,first defecation,promote milk secretion,and shorten time of satisfaction with breastfeeding.Its mechanism may be related to the regulation of MTL,GAS,VIP and PRL.