通腑泻热灌肠合剂治疗小儿粘连性肠梗阻的疗效观察

Observation on curative effect of Tongfu Xierejie Guanchang Mixture in treating adhesive intestinal obstruction in children

目的 探讨通腑泻热灌肠合剂治疗小儿粘连性肠梗阻(AIO)的效果。方法 选取82例AIO患儿,利用简单随机分组法将患儿分为常规组(使用常规治疗)和灌肠组(在常规治疗基础上使用通腑泻热灌肠合剂治疗),每组41例。比较两组患儿的临床疗效,临床症状积分,胃肠功能恢复情况,血清炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]以及不良事件发生率。结果 灌肠组患儿治疗总有效率为92.68%,高于常规组的73.17%,差异有统计学意义(P<0.05)。治疗后3、5、7 d,两组患儿的临床症状积分均较治疗前降低,且灌肠组治疗后3、5、7 d临床症状积分(17.28±4.85)、(9.24±2.08)、(3.87±0.25)分均较常规组的(21.46±4.99)、(15.23±3.31)、(7.95±1.14)分低,差异有统计学意义(P<0.05)。治疗后,灌肠组首次排气时间(2.29±0.54)d、首次排便时间(3.35±0.83)d、胃管拔除时间(5.38±1.18)d、住院时长(7.34±1.14)d均较常规组的(2.68±0.66)、(4.28±1.08)、(6.19±1.21)、(8.64±1.02)d更短,差异有统计学意义(P<0.05)。治疗后,两组患儿CRP、IL-6、TNF-α水平均较治疗前降低,且灌肠组患儿CRP(5.39±1.59)mg/L、IL-6(23.58±4.69)pg/ml、TNF-α(18.62±4.24)ng/L均低于常规组的(9.44±2.77)mg/L、(31.28±5.36)pg/ml、(31.26±5.86)ng/L,差异有统计学意义(P<0.05)。两组患儿不良事件发生率比较,差异无统计学意义(P>0.05)。结论 通腑泻热灌肠合剂治疗小儿AIO疗效显著,可有效减轻患儿临床症状,缩短疾病恢复时间,且安全性高。

Objective To explore the effect of Tongfu Xierejie Guanchang Mixture in treating adhesive intestinal obstruction(AIO)in children.Methods A total of 82 children with AIO were selected and divided into a conventional group(treated with conventional treatment)and an enema group(treated with Tongfu Xierejie Guanchang Mixture on the basis of conventional treatment)by simple randomization method,with 41 cases in each group.Comparison was made on clinical efficacy,clinical symptom score,gastrointestinal function recovery,serum inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and the incidence of adverse events between the two groups.Results The total effective rate of treatment for children in the enema group was 92.68%,which was higher than 73.17%in the conventional group,and the difference was statistically significant(P<0.05).At 3,5 and 7 d after treatment,the clinical symptom scores of children in both groups were lower than those before treatment;the clinical symptom scores were(17.28±4.85),(9.24±2.08)and(3.87±0.25)points in the enema group at 3,5,and 7 d after treatment,which were lower than(21.46±4.99),(15.23±3.31)and(7.95±1.14)points in the conventional group;the difference was statistically significant(P<0.05).After treatment,the first exhaust time of the enema group was(2.29±0.54)d,the first defecation time was(3.35±0.83)d,the gastric tube removal time was(5.38±1.18)d and the length of hospital stay was(7.34±1.14)d,which were all shorter than(2.68±0.66),(4.28±1.08),(6.19±1.21),and(8.64±1.02)d in the conventional group,and the difference was statistically significant(P<0.05).After treatment,the levels of CRP,IL-6 and TNF-αin both groups were lower than those before treatment;the enema group had CRP of(5.39±1.59)mg/L,IL-6 of(23.58±4.69)pg/ml and TNF-αof(18.62±4.24)ng/L,which were lower than(9.44±2.77)mg/L,(31.28±5.36)pg/ml and(31.26±5.86)ng/L in the conventional group;the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion Tongfu Xierejie Guanchang Mixture is effective in the treatment of AIO in children,which can effectively relieve the clinical symptoms of children,shorten the recovery time,and has high safety.