平乐疏肝活血汤防治PLIF术后早期胃肠道并发症临床观察

Clinical Observation of Preventing and Treating Early Gastrointestinal Complications After PLIF Surgery with Pingle Liver-Soothing and Blood-Activating Decoction

目的:观察平乐疏肝活血汤防治后路腰椎椎间融合术(posterior lumbar interbody fusion,PLIF)术后早期胃肠道并发症的临床疗效。方法:将60例接受PLIF手术后出现胃肠道并发症的患者按照随机数字表法分为治疗组与对照组,每组30例。治疗组给予术后常规腹部按摩、穴位贴敷护理,并给予平乐疏肝活血汤治疗,对照组给予术后常规腹部按摩、穴位贴敷护理,并给予枸橼酸莫沙必利片口服治疗。观察治疗后两组的临床疗效、治疗前后两组患者的腹胀评分、腹痛评分及便秘症状积分,比较两组患者术后首次肛门排气、首次排便时间、胃肠道激素及炎症因子水平的差异。结果:治疗组有效率为93.3%,对照组有效率为70.0%,治疗组有效率高于对照组,差异有统计学意义(P<0.05);治疗组治疗后腹胀评分、腹痛评分及便秘症状评分低于对照组,差异具有统计学意义(P<0.05);治疗组术后首次排气时间、首次排便时间短于对照组,差异具有统计学意义(P<0.05);治疗组治疗后促胃动素、生长抑素及胆囊收缩素水平高于对照组,差异具有统计学意义(P<0.05);治疗组治疗后白细胞计数、C反应蛋白及降钙素原水平低于对照组,差异具有统计学意义(P<0.05)。结论:平乐疏肝活血汤防治PLIF术后早期胃肠道并发症,能减轻腹痛、腹胀及便秘症状,促进术后排气、排便,提高促胃动素、生长抑素及胆囊收缩素水平,降低白细胞计数、C反应蛋白及降钙素原水平。

Objective:To observe the clinical efficacy of Pingle Liver-Soothing and Blood-Activating Decoctionon preventing and treating early gastrointestinal complications after posterior lumbar interbody fusion(PLIF) surgery.Methods:A total of 60 patients who developed gastrointestinal complications after PLIF surgery were randomly divided into the treatment group and the control group according to the random number table method,with 30 cases in each group.The treatment group received postoperative routine abdominal massage and acupoint application care,as well as Pingle Liver-Soothing and Blood-Activating Decoction.The control group received postoperative routine abdominal massage and acupoint application care,as well as Mosapride citrate for oral administration.Then the clinical efficacy,the differences in the abdominal distension score,abdominal pain score,and constipation symptom score of the two groups before and after treatment were observed.The postoperative first anal discharge,first defecation time,gastrointestinal hormone and inflammatory factor levels between the two groups were compared.Results:The effective rate of the treatment group was 93.3%,while that of the control group was 70.0%.The effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the postoperative abdominal distension score,abdominal pain score,and constipation symptom score in the treatment group were lower than those in the control group,and the differences were statistically significant(P<0.05);the first postoperative defecation time and first defecation time in the treatment group were shorter than those in the control group,and the difference was statistically significant(P<0.05);the levels of motilin,somatostatin,and cholecystokinin in the treatment group were higher than those in the control group,and the differences were statistically significant(P<0.05);the white blood cell count,C-reactive protein,and procalcitonin levels in the treatment group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Pingle Liver-Soothing and Blood-Activating Decoction can prevent and treat early gastrointestinal complications after PLIF surgery,alleviate abdominal pain,bloating,and constipation symptoms,promote postoperative exhaust and defecation,increase levels of motilin,somatostatin,and cholecystokinin,and reduce white blood cell count,C-reactive protein,and procalcitonin levels.