穴位敷贴结合中药灌肠在腹股沟疝合并便秘的老年患者术后的治疗效果

Comparative study on the therapeutic effect of acupoint application combined with traditional Chinese medicine enema in elderly patients with inguinal hernia complicated with constipation

目的探究穴位敷贴结合中药灌肠治疗腹腔镜腹股沟疝术后便秘患者的临床疗效。方法选择2017年1月至2020年1月于河北省秦皇岛市第一医院收治的腹腔镜腹股沟疝合并便秘的老年患者60例,根据随机数字表法将其分为2组。对照组采用腹腔镜经腹腹膜前疝修补术(TAPP),对患者采用常规通便药物治疗;试验组在对照组的基础上使用中药灌肠联合穴位敷贴进行治疗。观察2组患者治疗方案的临床疗效、胃肠激素水平、临床便秘症状评估积分变化情况、临床不良反应发生情况及术后腹股沟疝及便秘复发情况。结果治疗后,试验组临床疗效及胃肠激素水平改善程度均高于对照组(P<0.05);在便秘症状评估积分中,试验组各维度积分均小于对照组(P<0.05),2组患者不良反应发生情况无明显差异(P>0.05);试验组便秘复发率小于对照组(P<0.05)。术后随访1〜3年,试验组与对照组腹股沟疝复发情况分别为0、2例(6.67%);便秘复发率分别为1例(3.33%)、7例(23.33%),差异均有统计学意义(χ^(2)=0.03、5.19,P=0.01、0.02)。结论穴位敷贴结合中药灌肠治疗TAPP术后便秘能够取得较好的治疗效果,并且能显著改善老年患者的临床便秘症状及胃肠激素水平,预后效果良好,对于预防腹股沟疝复发有一定作用。

Objective To explore the clinical efficacy of acupoint application combined with traditional Chinese medicine enema in the treatment of constipation after laparoscopic inguinal hernia.Methods Sixty elderly patients with laparoscopic inguinal hernia complicated by constipation admitted to Qinhuangdao First Hospital in Hebei Province from January 2017 to January 2020 were analyzed.According to the random number table method,they were divided into two groups on average.The control group received TAPP surgery,and the patients received conventional laxative drugs.The experimental group was treated with traditional Chinese medicine enema combined with acupoint application on the basis of the control group,and the clinical efficacy,gastrointestinal hormone levels,changes in clinical constipation symptom evaluation score,clinical adverse reactions,postoperative inguinal hernia and constipation recurrence of the two groups were observed.Results After treatment,the clinical efficacy of the experimental group was higher(P<0.05),and the improvement degree of gastrointestinal hormone level was higher than that of the control group(P<0.05).In the evaluation score of constipation symptoms,the scores of all dimensions of the experimental group were lower than those of the control group(P<0.05),and there was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).The recurrence rate of constipation in the experimental group was lower(P<0.05).After postoperative follow-up of 1 to 3 years,inguinal hernia recurrence was 0%and 2(6.67%)respectively;constipation recurrence rate was 1(3.33%)and 7(23.3.3%)respectively(χ^(2)=0.03,5.19;P=0.01,0.02).Conclusion Acupoint application combined with traditional Chinese medicine enema in the treatment of constipation after TAPP can achieve good therapeutic effect and can significantly improve the clinical constipation symptoms and gastrointestinal hormone levels of elderly patients,with good prognostic effect,and has a certain role in preventing the recurrence of inguinal hernia.