文献类型：期刊文献

中文题名：醋甘遂在联合治疗术后早期炎性肠梗阻中的疗效观察

英文题名：Clinical effect observation on Vinegar-Preparing Euphorbia Gansui in combined treatment for early postoperative inflammatory small bowel obstruction

作者：易剑锋[1,2];叶蓁蓁[3];潘海邦[1,2];王新平[2];易华[2];赵春霖[2];董小鹏[1,2]

第一作者：易剑锋

机构：[1]甘肃中医药大学临床医学院,甘肃兰州730000;[2]甘肃中医药大学附属医院外科,甘肃兰州730020;[3]西北民族大学医学院,甘肃兰州730030

第一机构：甘肃中医药大学临床医学院

年份：2016

卷号：33

期号：3

起止页码：59

中文期刊名：甘肃中医学院学报

外文期刊名：Journal of Gansu College of Traditional Chinese Medicine

语种：中文

中文关键词：术后早期炎性肠梗阻;醋甘遂;生长抑素;复方大承气汤;临床疗效

外文关键词：early postoperative inflammatory small bowel obstruction;Vinegar-Preparing Euphorbia Gansui;somatostatin;Compound Dachengqi Tang;clinical efficacy

摘要：目的探讨醋甘遂在联合治疗术后早期炎性肠梗阻(EPISBO)中的作用及疗效。方法回顾分析甘肃中医药大学附属医院诊治的103例术后早期炎性肠梗阻患者的临床资料,按治疗方法不同分为3组,A组采用常规治疗加复方大承气汤保留灌肠,B组在A组治疗的基础上联合使用醋甘遂胃管注入,C组在A组治疗的基础上联合使用醋甘遂胃管注入和生长抑素治疗。结果 3组患者腹痛、腹胀,恶心、呕吐,肛门停止排便、排气,电解质紊乱发生率及胃肠减压量均较同组治疗前显著下降(P<0.01)。与A组治疗后比较,B组和C组腹痛、腹胀,肛门停止排便、排气发生率及胃肠减压量均显著降低(P<0.05或P<0.01),C组电解质紊乱发生率显著降低(P<0.05);B组和C组腹痛、腹胀、呕吐缓解时间,肠鸣音恢复时间,排气、排便、开始进食时间,体温、白细胞计数恢复正常时间均显著短于A组(P<0.05或P<0.01)。与B组治疗后比较,C组电解质紊乱发生率及胃肠减压量均显著降低(P<0.05或P<0.01);C组腹痛、腹胀及呕吐缓解时间均显著短于B组(P<0.01)。A组、B组、C组治疗总有效率分别为80.0%,92.3%,100.0%,B组和C组总有效率显著高于A组(P<0.01),C组显著高于B组(P<0.01)。3组患者在治疗过程中均未见明显不良反应,无肾功能不全、休克、腹腔脓肿、脓毒血症等并发症发生;使用醋甘遂治疗的患者除排便次数增加外,未见心、肝、肾等损伤;所有患者住院期间无1例再次手术。结论醋甘遂联合治疗EPISBO具有胃肠功能恢复快、感染易控制的优点,可显著提高EPISBO的治疗效果。
Objective To evaluate the efficacy of Vinegar-Preparing Euphorbia Gansui in combined treatment for early postoperative inflammatory small bowel obstruction( EPISBO). Methods Retrospective analysis of clinical data of 103 cases with EPISBO who were treated at affiliated hospital of Gansu university of Chinese medicine was made. According to different treatments,the cases were divided into group A,group B and group C. Group A was given routine treatment and Compound Dachengqi Tang by retention enema. Based on that,Group B was given Vinegar-Preparing Euphorbia Gansui additionally; group C was intervened with Vinegar-Preparing Euphorbia Gansui and somatostatin. Results After treatment,the incidence of abdominal pain,abdominal distension,nausea,vomiting,non-exhausting,non-defecating,electrolyte disorder and gastrointestinal decompression amount declined among three groups( P < 0. 01). Compared with group A,the incidence of abdominal pain,abdominal distension,non-exhausting,non-defecating,and gastrointestinal decompression amount were lower than that of group B and C( P<0.05 or P<0.01). The incidence of electrolyte disorder was lower in group C( P < 0.05). The post-treatment remission time of abdominal pain,abdominal distension and vomiting and the recovery time of intestinal sound,exhausting,defecating,eating,body temperature and leukocyte count in group B and group C were lower than that of group A( P<0.05 or P<0.01). Compared with group B,the incidence of electrolyte disorder and gastrointestinal decompression amount and the post-treatment remission time of abdominal pain,abdominal distension and vomiting was lower than that of group C( P<0.05 or P<0.01). The total effective rates of group A,group B and group C were 80.0%,92.3% and 100.0% respectively,there was a significant difference( P < 0.01). Among 3 groups,there was no any obvious adverse reaction such as renal failure,shock,abdominal abscess,sepsis. The frequency of defecation increased during the treatment,there was no damage to heart,liver and kidney. No patient underwent reoperation while in hospital. Conclusion Vinegar-Preparing Euphorbia Gansui has important significance on the fast recovery of gastrointestinal function and easy infection control in combined treatment for EPISBO. It can improve the efficacy evidently.