Effect of Oral and Enema Treatment with Modified Taohe Chengqitang on Nerve-inflammation Mechanism of Early Intestinal Obstruction After Abdominal Surgery

GAO Cong; HAN Yong; LIN Da-yong; ZHANG Yu; CHEN Yun-fei

doi:10.13422/j.cnki.syfjx.2017160176

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Effect of Oral and Enema Treatment with Modified Taohe Chengqitang on Nerve-inflammation Mechanism of Early Intestinal Obstruction After Abdominal Surgery

更新时间：2024-01-04

- Effect of Oral and Enema Treatment with Modified Taohe Chengqitang on Nerve-inflammation Mechanism of Early Intestinal Obstruction After Abdominal Surgery
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 23, Issue 16, Pages: 176-181(2017)
- 作者机构：
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- 基金信息：
- DOI：10.13422/j.cnki.syfjx.2017160176
  CLC： R656
- Published：2017
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GAO Cong, HAN Yong, LIN Da-yong, et al. Effect of Oral and Enema Treatment with Modified Taohe Chengqitang on Nerve-inflammation Mechanism of Early Intestinal Obstruction After Abdominal Surgery[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(16): 176-181.
DOI：

GAO Cong, HAN Yong, LIN Da-yong, et al. Effect of Oral and Enema Treatment with Modified Taohe Chengqitang on Nerve-inflammation Mechanism of Early Intestinal Obstruction After Abdominal Surgery[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(16): 176-181. DOI： 10.13422/j.cnki.syfjx.2017160176.

摘要

目的：探讨加味桃核承气汤内服和灌肠治疗腹部术后早期肠梗阻的临床疗效及对神经介质和炎症因子的影响。方法：将138例患者采用入院先后顺序，随机按数字表法分为对照组和观察组各69例。两组患者均给予持续胃肠减压、补液、纠正酸碱平衡及水电解质紊乱、抗感染等综合基础治疗。对照组采用注射用头孢他啶，2.0 g/次，2次/d，静脉滴注，连续7 d；注射用生长抑素，6 mg·（24 h）-1，持续微泵泵入，连续3 d；甲硫酸新斯的明注射液，2 mL/次，肌肉注射。观察组在对照组治疗的基础上给予加味桃核承气汤胃管注入和灌肠，2剂/d。两组疗程均为7 d。记录腹痛减轻时间、腹胀缓解时间、肠鸣音恢复时间及通气排便时间、胃管留置时间、进食时间、体温恢复正常时间、白细胞计数恢复正常时间、住院时间；记录手术中转情况；进行治疗前后湿热瘀滞证评分；检测治疗前后血管活性肠肽（VIP），降钙素原（PCT），一氧化氮（NO），单核细胞趋化蛋白-1（MCP-1），血清白细胞介素-6（IL-6），肿瘤坏死因子-α （TNF-α）和C-反应蛋白（CRP）水平。结果：观察组临床疗效总有效率91.31%，高于对照组的75.37%（χ2 ＝6.618，P <0.01）；观察组腹痛减轻时间、腹胀缓解时间、肠鸣音恢复时间、首次通气时间、首次排便时间均短于对照组（P <0.01）；观察组管留置时间、进食时间、体温恢复正常时间、白细胞计数恢复正常时间和住院时间均短于对照组（P <0.01）；观察组中转手术率为5.8%，低于对照组的18.84%（χ2 ＝5.434，P <0.05）；治疗后观察组患者血清VIP，PCT和NO均低于对照组（P <0.01）；观察组患者血清MCP-1，IL-6，TNF-α和CRP水平均低于对照组（P <0.01）。结论：在西医常规治疗的基础上，加味桃核承气汤内服和灌肠治疗腹部术后早期肠梗阻患者，能调节神经介质，减轻炎症损伤，能解除肠梗阻，缩短病程，提高保守治疗的成功率，临床疗效优于单纯西医治疗。

Abstract

Objective: To discuss the clinical efficacy of oral and enema treatment with modified Taohe Chengqitang on early intestinal obstruction after abdominal surgery and its effect on neurological and inflammatory factors. Method: One hundred and thirty-eight patients were randomly divided into control group and observation group by random number table

with 69 cases in each group. Patients in control group got comprehensive therapies including persistent gastrointestinal decompression

rehydration

correction of acid-base balance and water and electrolyte disorder

and anti-infection. And they got ceftazidime for injection

2 g/time

for 7 days

somatostatin for injection for continuous micro pump pumped

6 mg/24 hours

for 3 days

and methicillin neostigmine injection

2 mL/time. intramuscular injection. The observation group in control group to the basis of modified Taohe Chengqitang into stomach and enema

2 dose/day. The course of treatment was for 7 days. Times of abdominal pain relief

abdominal distension relief

bowel sounds recovery and ventilation defecation

gastric tube retention

eating

body temperature recovery and white blood cell count recovery

length of stay and surgical transit were recorded. Before and after treatment

damp heat stasis syndromes were scored. And levels of vasoactive intestinal peptide (VIP)

procalcitonin (PCT)

nitric oxide (NO)

monocyte chemoattractant protein-1 (MCP-1)

serum interleukin-6 (IL-6)

tumor necrosis factor -α (TNF-α) and C-reactive protein (CRP) were detected. Result: The total clinical effective rate of traditional Chinese medicine(TCM)in observation group was 91.31%

which was higher than 75.37% in control group (χ2=6.618

P <0.01). Time of abdominal pain relief

abdominal distension relief

bowel sounds recovery

ventilation defecation

gastric tube retention

eating

body temperature recovery and white blood cell count recovery

length of stay and surgical transit were all shorter than those in control group (P <0.01). Transfection rate in observation group was 5.8%

which was lower than 18.84% in control group (χ2=5.434

P <0.05). After treatment

levels of VIP

PCT

MCP-1

IL-6

TNF-α and CRP were lower than those in control group (P <0.01). Conclusion: In addition to western medicine therapy

oral and enema treatment of modified Taohe Chengqitang can regulate nerve mediators

reduce inflammation damage

relieve intestinal obstruction

shorten the course of disease

and improve the success rate of conservative treatment for patients of early intestinal obstruction after abdominal surgery

with a better effect than pure western medicine therapy.

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