排气汤治疗肠道气滞证小儿不完全性肠梗阻的疗效及对其血清炎症因子和胃肠动力的影响

Efficacy of Paiqi Decoction in Treating Incomplete Intestinal Obstruction in Children with Intestinal Qi Stagnation Syndrome and Its Effects on Serum Inflammatory Factors and Gastrointestinal Motility

目的探讨排气汤治疗肠道气滞证小儿不完全性肠梗阻(Incomplete intestinal obstruction,IIO)的疗效及对其血清炎症因子和胃肠动力的影响。方法选取2019年12月—2021年12月期间陇南市第一人民医院收治的IIO患儿106例,按照随机数字表法分为对照组和观察组,每组各53例。对照组给予常规治疗,观察组在对照组基础上加服排气汤治疗,均治疗7 d。观察比较两组患儿临床疗效、症状恢复情况、不良反应,治疗前后中医证候积分、炎症因子[血清C反应蛋白(C-reactive protein,CRP)、白介素-1β(Interleukin-1β,IL-1β)和肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)],胃肠动力指标[血管活性肠肽(Vasoactivelntestnalpeptide,VIP)、胃泌素(Gastrin,GAS)和血浆胃动素(Motilin,MOT)]水平。结果治疗后观察组临床总有效率96.23%(51/53)明显高于对照组83.02%(44/53),差异有统计学意义(P<0.05)。治疗后两组患儿主症、次症症状积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组主症、次症症状积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组腹痛腹胀消失时间、排气时间、X线片正常时间、肠鸣音恢复时间、禁食时间均明显优于对照组,差异有统计学意义(P<0.05)。治疗后两组患儿血清CRP、IL-1β和TNF-α水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组血清炎症因子明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患儿VIP、GAS水平均较治疗前降低,MOT水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组VIP、GAS水平均明显低于对照组,MOT明显高于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患儿均未出现不良反应。结论排气汤治疗肠道气滞证小儿IIO能够提高疗效,改善症状,促进患儿恢复,其机制可能与减轻炎症反应,改善胃肠动力有关。

Objective To investigate the efficacy of Paiqi decoction in treating incomplete intestinal obstruction(IIO)in children with intestinal Qi stagnation syndrome and its effect on serum inflammatory factors and gastrointestinal motility.Methods A total of 106 children with IIO treated at The First People′s Hospital of Longnan between December 2019 and December 2021 were selected for this study.The children were randomly divided into a control group and an observation group according to the random number table method,with 53 cases in each group.The control group received conventional treatment,while the observation group received conventional treatment combined with Paiqi decoction.Both groups were treated for 7 days.Clinical efficacy,symptom recovery,and adverse reactions were observed and compared between the two groups.Traditional Chinese medicine(TCM)syndrome scores,inflammatory factors[serum C-reactive protein(CRP),interleukin-1β(IL-1β),and tumor necrosis factor-α(TNF-α)],and gastrointestinal motility indexes[vasoactive intestinal peptide(VIP),gastrin(GAS),and plasma motilin(MOT)]were measured before and after treatment.Results After treatment,the total clinical efficacy rate was significantly higher in the observation group at 96.23%(51/53)compared to 83.02%(44/53)in the control group,with a statistically significant difference(P<0.05).Both groups showed a significant reduction in primary and secondary symptom scores compared to pre-treatment levels,with statistically significant differences(P<0.05);the observation group showed significantly lower scores than the control group,with statistically significant differences(P<0.05).The observation group also showed significantly better improvement in terms of the time to relief from abdominal pain and bloating,time to first flatulence,time to normal X-ray results,time to recovery of bowel sounds,and duration of fasting compared to the control group,with statistically significant differences(P<0.05).Serum levels of CRP,IL-1βand TNF-αwere significantly reduced in both groups after treatment,with statistically significant differences(P<0.05);the observation group showed significantly lower levels than the control group,with statistically significant differences(P<0.05).Additionally,VIP and GAS levels were significantly lower,and MOT levels were significantly higher in both groups after treatment,with statistically significant differences(P<0.05);the observation group showed more pronounced changes than the control group,with statistically significant differences(P<0.05).No adverse reactions were observed in either group during the treatment period.Conclusion Paiqi decoction effectively treats IIO in children with intestinal Qi stagnation syndrome,improving symptoms and promoting recovery.Its mechanism may be related to the reduction of inflammation and the improvement of gastrointestinal motility.