中西医结合对术后早期炎性肠梗阻患者炎性因子的影响及疗效观察

Influence and the curative effect observation of traditional Chinese and western medicine on inflammatory factor in patients with early inflammatory intestinal obstruction after operation

目的:比较常规治疗联合针对性药物治疗与中西医结合治疗对术后早期炎性肠梗阻患者(EPII)炎性因子的影响及疗效,探讨中西医结合治疗对EPII的机制及优势。方法:2013年5月-2014年5月收治EPII患者143例,随机分为对照组71例和试验组72例,分别应用常规治疗+针对性药物治疗及在此基础上加服大承气汤并配合针灸疗法,观察两组患者治疗后肛门排气时间、肠鸣音恢复时间、腹胀腹痛缓解时间及治愈时间等指标;比较两组患者治疗前后血浆肿瘤坏死因子、白介素-6、超敏C反应蛋白及脂多糖水平;并对两组患者治疗后临床疗效进行分析。结果:试验组治疗后临床疗效指标优于对照组(P<0.01,P<0.05);两组患者治疗后各项指标较治疗前均有所降低,治疗2 d后试验组TNF-α、hs-CRP明显低于对照组(P<0.05),IL-6、LPS显著低于对照组(P<0.01);治疗4 d、6 d后试验组各项指标均显著低于对照组(P<0.01);试验组总有效率93.05%,对照组总有效率76.05%,差异有统计学意义(P<0.01)。结论:中西医结合在EPII治疗中具有一定的意义和疗效。

Objective:To compare the influence and the curative effect of conventional treatment combined with targeted drug therapy and combined treatment of TCM and western medicine on inflammatory factor in patients with early inflammatory intestinal obstruction after operation,to investigate the mechanism and advantage of traditional Chinese medicine and western medicine for treatment of EPII.Methods:143 cases of EPII patients were selected from May 2013 to May 2014.They were randomly divided into the control group of 71 cases and the experimental group of 72 cases.They were treated respectively by conventional treatment plus targeted drug therapy and Da Cheng Qi Decoction plus acupuncture therapy on the basis of it.We observed the anus exhaust time,recovery of bowel sound time,abdominal distension and pain relieving time and cure time after treatment of the two groups;we compared plasma tumor necrosis factor,interleukin-6,high sensitive C reactive protein and lipopolysaccharide levels before and after treatment of the two groups,and we analyzed the clinical effect.Results:After the treatment,in the experimental group,the clinical efficacy was better than that of the control group(P<0.01,P<0.05);after treatment,compared with before treatment the indexes of two groups of patients were reduced;after 2 days treatment,in the experimental group,TNF- alpha,hs-CRP content were significantly lower than the control group(P<0.05);IL-6,LPS content were significantly lower than that of control group(P<0.01);after treatment of 4 days and 6 days,in the experimental group,the indicators were significantly lower than those in control group(P<0.01).In the experimental group,the total efficiency was 93.05%;in the control group,the total efficiency was 76.05%;the difference was statistically significant(P<0.01).Conclusion:Combine traditional Chinese and western medicine had certain significance and efficacy in the treatment of EPII.