补中益气汤联合穴位贴敷治疗术后早期炎性肠梗阻临床研究

Clinical study on the treatment of early postoperative inflammatory small bowel obstruction with Buzhong Yiqi decoction combined with acupoint sticking

目的 探讨补中益气汤联合穴位贴敷治疗术后早期炎性肠梗阻(EPISBO)的临床效果。方法 纳入石家庄市中医院2019年6月至2022年3月收治的EPISBO病人110例,按随机数字表法分为对照组和治疗组(n=55),所有病人给予胃肠减压、静脉液体复苏、纠正水电解质及酸碱平衡紊乱、抗感染等基础对症治疗,对照组病人在基础对症治疗的基础上给予穴位贴敷治疗,治疗组病人在对照组的基础上加服补中益气汤,治疗周期为7 d。观察两组血清白细胞介素-1β(IL-1β)、内毒素、血管活性肽(VIP)、一氧化氮(NO)、去甲肾上腺素(NE)、5-羟色胺(5-HT)水平、胃肠功能改善时间、临床疗效以及不良反应发生率。结果 治疗组总有效率(92.73%)显著高于对照组(78.18%)(P<0.05);治疗1 d、7 d后,两组血清IL-1β、内毒素水平均显著降低,且治疗组低于对照组(P<0.05);治疗1 d、7 d后,两组血清VIP、NO、NE、5-HT水平均显著降低,且治疗7 d后治疗组血清VIP、NO、NE水平显著低于对照组(P<0.05);治疗组肠鸣音恢复时间、肛门排气恢复时间、进食恢复时间、住院时间均显著低于对照组(P<0.05)。结论 补中益气汤联合穴位贴敷对EPISBO病人的临床疗效显著,可有效降低血清IL-1β、内毒素水平,改善胃肠功能。

Objective To investigate the clinical effect of Buzhong Yiqi decoction combined with acupoint sticking on early postoper-ative inflammatory small bowel obstruction(EPISBO).Methods One hundred and ten EPISBO patients admitted to Shijiazhuang Tra-ditional Chinese Medicine Hospital from June 2019 to March 2022 were included and grouped into control group(n=55)and treatment group(n=55)according to random number table method.All patients were given basic symptomatic treatment such as gastrointestinal decompression,intravenous fluid resuscitation,correction of water-electrolyte and acid-base balance disorders,and anti-infection.The patients in the control group were given acupoint sticking therapy on the basis of basic symptomatic treatment,and the patients in the treatment group were treated with Buzhong Yiqi decoction on the basis of the control group therapy,and the treatment cycle was 7 days.The levels of serum interleukin-1β(IL-1β),endotoxin(LPS),vasoactive peptide(VIP),nitric oxide(NO),norepinephrine(NE),5-hy-droxytryptamine(5-HT),the improvement time of gastrointestinal function,clinical efficacy and incidence of adverse reactions were ob-served.Results The total effective rate in the treatment group(92.73%)was obviously higher than that in the control group(78.18%)(P<0.05);after 1 d and 7 d of treatment,the serum levels of IL-1βand LPS in both groups were obviously decreased,and the treatment group were lower than the control group(P<0.05);after 1 d and 7 d of treatment,the levels of serum VIP,NO,NE,and 5-HT in both groups were obviously decreased,and after 7 d of treatment,the levels of serum VIP,NO,and NE in the treatment group were obviously lower than those in the control group(P<0.05);the recovery time of bowel sounds,anal exhaust recovery time,eating recovery time and hospitalization time in the treatment group were obviously lower than those in the control group(P<0.05).Conclusion Buzhong Yiqi decoction combined with acupoint sticking has a significant clinical effect on patients with EPISBO,can effectively reduce serum IL-1βand LPS levels,and ameliorate gastrointestinal function.