枳术汤辅助治疗对剖宫产术后产妇肠动力恢复和血清胃泌素、泌乳素的影响

Effects of adjuvant therapy with Zhizhu decoction on postoperative recovery of gastrointestinal motility,serum gastrin and prolactin after cesarean section

目的:探讨枳术汤辅助治疗对剖宫产产妇术后肠动力恢复和血清胃泌素、泌乳素的影响。方法:选取行剖宫产手术产妇100例,随机将产妇分为观察组和对照组,各50例。对照组采用常规对症支持治疗,观察组在对照组基础上采用枳术汤治疗,均持续治疗6 d。比较两组临床疗效、胃肠道功能恢复情况比较、术后5 d泌乳情况。比较两组产妇治疗前后血清胃泌素(GAS)、血管活性肠肽(VIP)及胃动素(MTL)水平。比较两组术后5 d血清血红蛋白值、泌乳素及新生儿黄疸指数水平。记录两组治疗期间的并发症情况。结果:观察组治疗总有效率高于对照组(P<0.05)。观察组肠鸣音恢复时间、首次排气时间和首次排便时间均小于对照组,术后24 h排气率和排便率均明显高于对照组(P<0.05)。观察组术后开始泌乳时间小于对照组,泌乳正常及以上比例高于对照组(P<0.05)。治疗后观察组GAS、MTL、泌乳素水平均明显高于对照组,VIP、新生儿黄疸指数水平均低于对照组。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:枳术汤治疗可以明显促进剖宫产产妇胃肠道功能恢复,缩短产妇泌乳时间,增加泌乳量。

Objective:To explore the effects of adjuvant therapy with Zhizhu decoction on the recovery of gastrointestinal motility,serum gastrin(GAS)and prolactin in postportum women after cesarean section.Methods:According to simple random grouping method,100 patients undergoing cesarean section were divided into observation group and control group,50 cases in each group.The control group was given routine symptomatic support treatment,while observation group was treated with Zhizhu decoction on basis of control group.All were continuously treated for 6 d.The clinical curative effect,recovery of gastrointestinal function,lactation at 5 d after surgery,levels of serum GAS,vasoactive intestinal peptide(VIP)and motilin(MTL)before and after treatment,and levels of hemoglobin,prolactin and neonatal jaundice index at 5 d after surgery were compared between the two groups.The complications during treatment in both groups were recorded.Results:The response rate of treatment in observation group was significantly higher than that in control group(P<0.05).The recovery time of bowel sounds,the first exhaust time and the first defecation time in observation group were significantly shorter than those in control group(P<0.05),exhaust and defecation rates at 24 h after surgery were significantly higher than those in control group(P<0.05).The postoperative start time of lactation in observation group was earlier than that in control group,and proportion of cases with normal and better lactation was higher than that in control group(P<0.05).After treatment,levels of GAS,MTL and prolactin in observation group were significantly higher than those in control group,while levels of VIP and neonatal jaundice index were lower than those in control group.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The Zhizhu decoction can significantly promote the recovery of gastrointestinal function,shorten lactation time and increase lactation yield in postportum women after cesarean section.