厚朴排气合剂联合针刺穴位对胸腰椎术后胃肠功能恢复的影响

Effects of Houpu Paiqi Mixtures combined with acupoint acupuncture on the gastrointestinal function recovery after thoracolumbar surgery

目的探讨厚朴排气合剂联合针刺穴位对胸腰椎术后胃肠功能恢复的影响。方法选择我院脊柱科2019年5月-2020年5月收治的胸腰椎术后病人150例,随机分为中药组(n=48)、针刺组(n=52)和针药并用组(n=50),中药组给予厚朴排气合剂治疗,针刺组给予针刺穴位治疗,针药并用组给予上述疗法联合治疗,评估3组治疗后的临床疗效,对比3组术后胃肠功能恢复情况、治疗前后的血清胃肠激素含量及治疗后3 h和3 d的炎症指标水平。结果针药并用组的总有效率高于中药组和针刺组(P<0.05),针药并用组的肠鸣音恢复时间、首次排气时间及首次排便时间均短于中药组和针刺组(P<0.05),中药组和针刺组对比无统计学意义(P>0.05);治疗后,3组血清GAS、MTL含量比较,针药并用组高于中药组和针刺组(P<0.05),中药组和针刺组对比无统计学意义(P>0.05),术后3 d炎症指标水平低于术后3 h(P<0.05),针药并用组变化幅度大于中药组和针刺组(P<0.05),中药组和针刺组对比无统计学意义(P>0.05)。结论厚朴排气合剂联合针刺穴位能提高胸腰椎术后患者疗效,促进胃肠功能恢复,调节胃肠激素水平,减轻术后炎症反应。

Objective To explore the effects of Houpu Paiqi Mixtures combined with acupoint acupuncture on the gastrointestinal function recovery after thoracolumbar surgery.Methods A total of 150 patients undergoing thoracolumbar surgery in the department of spine of our hospital from 2019 to 2020 were selected and randomly divided into a traditional Chinese medicine group(n=48),an acupuncture group(n=52)and an acupuncture-medicine combination group(n=50).The traditional Chinese medicine group was treated with Houpu Paiqi Mixtures,while the acupuncture group was treated with acupoint acupuncture,and the acupuncture-medicine combination group was given the combination of the above two therapies.The clinical efficacy of the three groups was evaluated,and the postoperative gastrointestinal function recovery and levels of serum gastrointestinal hormones before and after treatment were compared among the three groups,and the levels ofinflammatory indicators 3 hours and 3 days after treatment were compared among the three groups.Results The total clinical effective rate in the acupuncture-medicine combination group was significantly higher than that in the traditional Chinese medicine group and the acupuncture group(P<0.05).The bowel sound recovery time,first exhaust time and first defecation time in the acupuncture-medicine combination group were significantly shorter than those in the traditional Chinese medicine group and the acupuncture group(P<0.05),yet there was no significant difference between the traditional Chinese medicine group and the acupuncture group(P>0.05).After treatment,the levels of serum gastrointestinal hormones[gastrin(GAS),motilin(MTL)]in the acupuncture-medicine combination group were higher than those in the traditional Chinese medicine group and the acupuncture group(P<0.05),while there was no significant difference between the traditional Chinese medicine group and the acupuncture group(P>0.05).The levels ofinflammatory indicators[C-reactive protein(CRP)and procalcitonin(PCT)]3 days after surgery was lower than those 3 hours after surgery(P<0.05),and the change range in the acupuncture-medicine combination was greater than that in the traditional Chinese medicine group and the acupuncture group(P<0.05),yet there was no significant difference between the traditional Chinese medicine group and the acupuncture group(P>0.05).Conclusion Houpu Paiqi Mixtures combined with acupoint acupuncture can improve the efficacy of patients after thoracolumbar surgery,effectively promote the recovery of gastrointestinal functions,regulate the levels of gastrointestinal hormones,and reduce postoperative inflammatory responses.