攻下逐瘀汤治疗胸腰椎骨折患者术后便秘疗效分析

Clinical Efficacy of Gongxia Zhuyu Decoction in Treating Constipation Following Surgery for Thoracolumbar Fracture

目的探讨攻下逐瘀汤治疗胸腰椎骨折患者术后便秘的临床疗效。方法选取2018年5月至2020年6月南阳医学高等专科学校第一附属医院收治的102例胸腰椎骨折术后便秘患者作为研究对象,按照不同治疗方式将其分为观察组(51例)和对照组(51例)。观察组患者在口服乳果糖口服液的基础上加服攻下逐瘀汤治疗,对照组患者单纯口服乳果糖口服液治疗,对比两组患者便秘评分、中医症候积分、临床疗效以及并发症发生情况。结果治疗3周后,观察组患者便秘评分及中医症候中主症、兼症积分均明显低于对照组(t=9.299、5.357、6.046,P均<0.001);观察组患者中显效20例、有效26例、无效5例,明显优于对照组患者的显效12例、有效19例、无效20例(Z=-2.991,P=0.003)。治疗过程中,观察组患者出现腹痛3例,并发症发生率为5.88%,明显低于对照组患者出现的腹痛7例、肠梗阻5例,并发症发生率23.53%(χ^(2)=6.331,P=0.012)。结论攻下逐瘀汤治疗胸腰椎骨折患者术后便秘,可有效改善患者临床症状,提高临床疗效,降低并发症发生率,值得临床推广应用。

Objective To investigate the clinical efficacy of Gongxia Zhuyu Decoction in treating constipation following surgery for thoracolumbar fractures.Methods 102 patients suffering from constipation following surgery for thoracolumbar fractures,admitted to the First Affiliated Hospital of Nanyang Medical College from May 2018 to June 2020,were enrolled as research subjects and divided into observation group(n=51)who received oral administration of Gongxia Zhuyu Decoction plus Lactulose Oral Solution,and control group(n=51)who only received Lactulose Oral Solution.The constipation score,TCM syndrome score,clinical efficacy and complication occurrence of patients were compared between the two groups.Results After three weeks of treatment,the constipation score and the scores of main symptoms and minor symptoms of TCM syndromes in observation group were significantly lower than that in control group(t=9.299,5.357 and6.046,allP<0.001).In observation group,20 cases were markedly effective,26 cases were effective,5 cases were ineffective,which was much better than control group with 12 cases markedly effective,19 cases effective and 20 cases ineffective(Z=-2.991,P=0.003).During the course of treatment,3 cases developed abdominal pain in observation group,and the incidence of complications was 5.88%,which was significantly lower than 23.53%in control group(χ^(2)=6.331,P=0.012)-7 cases with abdominal pain and 5 cases with intestinal obstruction.Conclusion In the treatment of postoperative constipation in patients underwent surgery for thoracolumbar fracture,Gongxia Zhuyu Decoction can effectively improve clinical symptoms and therapeutic effects,and greatly reduce the incidence of complications.