厚朴三物汤对腹腔镜子宫切除术后患者胃肠功能影响的临床研究

Clinical Research on the Effect of Houpu Sanwu Decoction on Gastrointestinal Function in Patients after Laparoscopic Hysterectomy

目的探讨厚朴三物汤对经腹腔镜下行全子宫切除术的患者胃肠功能恢复的影响。方法随机选取2021年1—12月徐州市中医院妇科收治的70例行全子宫切除手术的患者为研究对象,按照随机数表法分为对照组(35例,常规术后治疗)、研究组(35例,常规术后治疗基础上加用厚朴三物汤)。比较两组胃肠功能恢复、中医症状评分、血清炎症指标及不良反应情况。结果研究组肠鸣音恢复时间、术后首次排气时间及术后首次排便时间均少于对照组,差异有统计学意义(P<0.05)。研究组术后24、72 h腹胀及恶心呕吐症状评分均低于对照组,差异有统计学意义(P<0.05)。术前,两组血清炎症指标相近,差异无统计学意义(P>0.05);术后24、72 h,研究组TNF-α、IL-6、CRP水平均低于对照组,差异有统计学意义(P<0.05)。研究组不良反应发生率为0.00%低于对照组的5.71%,但差异无统计学意义(P>0.05)。结论常规术后治疗基础上加用厚朴三物汤能够明显促进经腹腔镜全子宫切除术后患者胃肠功能的恢复,减轻患者腹胀及恶心呕吐症状,降低血清炎症因子水平,可用于妇科术后快速康复方案。

Objective To investigate the effect of Houpu Sanwu Decoction on gastrointestinal function recovery in patients undergoing total hysterectomy under laparoscope.Methods A total of 70 patients undergoing total hysterectomy admitted to the Department of Gynecology of Xuzhou Hospital of Traditional Chinese Medicine from January to December 2021 were randomly selected as research objects,and were divided into the control group(35 cases,conventional postoperative treatment)and the study group(35 cases,conventional postoperative treatment plus Hopu Sanwu decoction)according to random number table method.Gastrointestinal function recovery,TCM symptom score,serum inflammatory indexes and adverse reactions were compared between the two groups.Results The recovery time of bowel sound,first postoperative exhaust time and first postoperative defecation time in the study group were less than those in the control group,and the difference was statistically significant(P<0.05).The scores of abdominal distension,nausea and vomiting in the study group were lower than those in the control group 24 h and 72 h after surgery,and the differences were statistically significant(P<0.05).Before surgery,serum inflammatory indexes were similar between the two groups,the difference was not statistically significant(P>0.05).The levels of TNF-α,IL-6 and CRP in the study group were lower than those in the control group 24 h and 72 h after surgery,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group 0.00%was lower than that in the control group(5.71%),but and the difference was not statistically significant(P>0.05).Conclusion Based on conventional postoperative treatment,the addition of Houpu Sanwu Decoction can significantly promote the recovery of gastrointestinal function,reduce the symptoms of abdominal distension,nausea and vomiting,and reduce the level of serum inflammatory factors in patients with laparoscopic total hysterectomy,which can be used for rapid rehabilitation program after gynecological surgery.