子午捣臼法联合柴平汤治疗腹腔镜胆囊切除术后胃肠功能紊乱临床观察

Effect of Ziwu Daojiu Method Combined with Chaiping Decoction(柴平汤)on Treating Gastrointestinal Dysfunction after Laparoscopic Cholecystectomy

目的探讨子午捣臼法联合柴平汤治疗腹腔镜胆囊切除术后胃肠功能紊乱的疗效。方法选取2020年1月—2021年1月期间于辽阳市传染病医院进行腹腔镜胆囊切除患者134例,术后按照治疗方法分为对照组和观察组(各67例),对照组给予柴平汤治疗,观察组在此基础上联合子午捣臼法治疗,比较两组患者胃肠功能恢复情况(首次排气时间、首次排便时间、住院时间、肠鸣音恢复时间),两组患者治疗前和治疗1周后临床症状(腹胀、腹痛、恶心、乏力、发热、腹部压痛、排气排便障碍)评分和治疗前、治疗1周后胃肠激素[胃动素(MTL)、胃泌素(GAS)和血管活性肠肽(VIP)、饥饿素(GHRL)]水平和临床治疗效果。结果观察组首次排气时间、首次排便时间、住院时间、肠鸣音恢复时间均明显短于对照组,差异具有统计学意义(P<0.05)。治疗前,两组患者腹胀、腹痛、恶心、乏力、发热、腹部压痛、排气排便障碍临床症状评分比较差异无统计学意义(P>0.05),治疗后两组患者腹胀、腹痛、恶心、乏力、发热、腹部压痛、排气排便障碍临床症状评分较治疗前明显降低(P<0.05),且观察组均明显低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组患者MTL、GAS、VIP、GHRL水平比较差异无统计学意义(P>0.05),治疗后,两组患者MTL、GAS水平较治疗前明显升高(P<0.05),且观察组高于对照组,两组患者VIP、GHRL水平较治疗前明显降低,且观察组低于对照组(P<0.05)。观察组临床治疗有效率94.03%(63/67)高于对照组82.09%(55/67)(χ^(2)=4.542,P=0.033)。结论给予腹腔镜胆囊切除术后胃肠功能紊乱患者子午捣臼法联合柴平汤治疗能够有效改善患者胃肠功能,减轻患者腹部不适症状,促进胃肠激素水平改善,临床治疗效果较好。

Objective To investigate the effect of Ziwu Daojiu method combined with Chaiping Decoction(柴平汤)in the treatment of gastrointestinal dysfunction after laparoscopic cholecystectomy.Methods 134 patients who underwent laparoscopic cholecystectomy in Liaoyang infectious disease Hospital from January 2020 to January 2021 were selected.After the operation,they were divided into control group and observation group(67 cases in each)according to the treatment method.The control group was given Chaiping Decoction for treatment,the observation group was combined with the Ziwu Daojiu method on this basis.The gastrointestinal function recovery of the two groups of patients was compared(first exhaust time,first defecation time,hospitalization time,bowel sound recovery time),and the two groups of patients before treatment and after 1 week of treatment,clinical symptoms(abdominal distension,abdominal pain,nausea,fatigue,fever,abdominal tenderness,gas and defecation disorders)scores and before treatment and 1 week after treatment gastrointestinal hormones[motilin(MTL),gastrin(GAS)and vasoactive intestinal peptide(VIP),ghrelin(GHRL)]levels and clinical treatment effects.Results The observation group’s first exhaust time,first defecation time,hospitalization time,and bowel sound recovery time were significantly shorter than those of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in clinical symptom scores between the two groups of patients with abdominal distension,abdominal pain,nausea,fatigue,fever,abdominal tenderness,and gas and defecation disorders(P>0.05).After treatment,the two groups of patients had abdominal distension,abdominal pain,nausea,and fatigue The scores of clinical symptoms of fever,abdominal tenderness,gas and defecation disorders were significantly lower than those before treatment(P<0.05),and the observation group was significantly lower than the control group,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of MTL,GAS,VIP and GHRL between the two groups of patients(P>0.05).After treatment,the levels of MTL and GAS of the two groups were significantly higher than those before treatment(P<0.05).The group was higher than the control group,the levels of VIP and GHRL in the two groups were significantly lower than before treatment,and the observation group was lower than the control group(P<0.05).The effective rate of clinical treatment in the observation group was 94.03%(63/67)higher than 82.09%(55/67)in the control group(χ^(2)=4.542,P=0.033).Conclusion Treating patients with gastrointestinal dysfunction after laparoscopic cholecystectomy with Ziwu Daojiu method combined with Chaiping Decoction can effectively improve the gastrointestinal function of the patients,reduce the symptoms of abdominal discomfort,and promote the improvement of gastrointestinal hormone levels.The clinical treatment effect is good.