| 引用本文: |
李澜,王永恒,黄湘俊.经鼻肠梗阻导管联合大承气汤治疗术后早期气虚血瘀型炎性肠梗阻的临床疗效研究[J].湖南中医药大学学报,2023,43(2):299-303[点击复制] |
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| 经鼻肠梗阻导管联合大承气汤治疗术后早期气虚血瘀型炎性肠梗阻的临床疗效研究 |
| 李澜,王永恒,黄湘俊 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 目的 探讨经鼻肠梗阻导管联合大承气汤对术后早期气虚血瘀型炎性肠梗阻的临床疗效。方法 选择2020年1月至2022年6月湖南中医药大学第一附属医院普外微创胃肠外科符合本研究纳入标准的肠梗阻患者24例。将患者随机分为实验组（12例）和对照组（12例）。两组均在诊断明确且观察48 h仍未好转后，置入经鼻肠梗阻导管。对照组予以常规治疗，实验组在对照组治疗基础上联合大承气汤治疗。比较两组患者腹胀及腹痛症状出现缓解的时间、胃肠液引流量开始减少的时间、肛门或造口排气及排便恢复时间、腹部平片液平面消失时间、导管拔除时间和平均住院时间；每3天复查1次血清学指标；并比较两组患者在治疗后炎症指标以及总有效率。结果 对照组患者平均腹胀及腹痛症状出现缓解的时间、胃肠液引流量开始减少的时间、排气及排便恢复时间、腹部平片液平面消失时间、导管拔除时间、平均住院时间普遍长于实验组（P<0.05）；实验组患者白细胞(white blood cell, WBC)、C反应蛋白(C-reactive protein, CRP)、降钙素原(procalcitonin, PCT)炎性指标较对照组明显下降（P<0.05）；实验组总有效率比对照组高(P<0.05）。结论 经鼻肠梗阻导管联合大承气汤对术后早期气虚血瘀型炎性肠梗阻腹胀、腹痛及排气、排便有明显的改善作用，治疗后炎症指标明显下降，总有效率较单一使用经鼻肠梗阻导管高。 |
| 关键词: 经鼻肠梗阻导管 大承气汤 术后早期炎性肠梗阻 气虚血瘀型 临床疗效 |
| DOI：10.3969/j.issn.1674-070X.2023.02.020 |
| 投稿时间：2022-10-13 |
| 基金项目:湖南省卫生健康委员会重点指导课题（C202304019709）；湖南省卫生健康委员会适宜技术推广项目（20221801591）；湖南中医药大学校级课题一般项目（2019XJJJ049）。 |
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| Clinical efficacy of transnasal ileus catheter combined with Dachengqi Decoction in treating early postoperative inflammatory ileus with qi deficiency and blood stasis |
| LI Lan,WANG Yongheng,HUANG Xiangjun |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Objective To explore the clinical efficacy of transnasal intestinal obstruction catheter combined with Dachengqi Decoction on early postoperative inflammatory ileus with qi deficiency and blood stasis. Methods A total of 24 patients with early intestinal obstruction after abdominal surgery that were transferred to the department of the First Hospital of Hunan University of Chinese Medicine from January 2020 to June 2022 were selected as objects that conform to the criteria. These patients were randomly divided into experimental group and control group, with 12 patients in each group. In both groups, transnasal intestinal obstruction catheter was inserted after 48 h of definite diagnosis and with no improvement. The control group was given conventional treatment, while the experimental group was treated with Dachengqi Decoction on the basis of conventional treatment The relief time of abdominal distension and abdominal pain, the time of reduction of gastric and intestinal fluid drainage, the recovery time of anal or stoma exhaust and defecation, the time of disappearance of abdominal plain film liquid and gas level, the time of catheter removal, and the average length of hospital stay were compared between two groups. The changes of inflammatory indicators and the effective rate after treatment were also compared between two groups. Results The average relief time of abdominal distension and abdominal pain, the time of reduction for gastric and intestinal fluid drainage, the recovery time of exhaust and defecation, the time of disappearance of abdominal plain film liquid and gas level, the time of catheter removal,and the average length of hospital stay in control group were generally longer than those in experimental group (P<0.05); the inflammatory indexes of white blood cell (WBC), C-reactive protein (CRP) and procalcitonin (PCT) in experimental group were significantly reduced compared with those in control group (P<0.05); the total effective rate of experimental group was higher than that of control group (P<0.05). Conclusion Transnasal intestinal obstruction catheter combined with Dachengqi Decoction can significantly improve early postoperative inflammatory ileus with qi deficiency and blood stasis, abdominal distension, abdominal pain, exhaust, and defecation. After treatment, the inflammatory indicators are significantly reduced, and the overall effective rate is higher than that of the single use of intestinal obstruction catheter. |
| Key words: transnasal ileus catheter Dachengqi Decoction early postoperative inflammatory ileus qi deficiency and blood stasis clinical efficacy |
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