Clinical Efficacy of Modified Da Chengqitang by Enema on Treatment if Postoperative Inflammatory Intestinal Obstruction

Gang LI; Wen-yun WANG; Zhong-fu MA; Feng-chang ZHENG; Jie-xiang TIAN; Cheng-ji ZHAO

doi:10.13422/j.cnki.syfjx.20191533

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Clinical Efficacy of Modified Da Chengqitang by Enema on Treatment if Postoperative Inflammatory Intestinal Obstruction

Clinic | 更新时间：2021-02-09

- Clinical Efficacy of Modified Da Chengqitang by Enema on Treatment if Postoperative Inflammatory Intestinal Obstruction
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 25, Issue 17, Pages: 76-81(2019)
- 作者机构：
  
  1.兰州大学　第二医院，兰州　 730030；
  2.甘肃省肿瘤医院，兰州　 730050；
  3.甘肃省中医学院　附属医院，兰州　 730000
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20191533
  CLC： R289; R272; R272.4
- Received：04 March 2019，
  
  Published Online：10 April 2019，
  
  Published：05 September 2019
- 稿件说明：
移动端阅览
Gang LI, Wen-yun WANG, Zhong-fu MA, et al. Clinical Efficacy of Modified Da Chengqitang by Enema on Treatment if Postoperative Inflammatory Intestinal Obstruction[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(17): 76-81.
DOI：

Gang LI, Wen-yun WANG, Zhong-fu MA, et al. Clinical Efficacy of Modified Da Chengqitang by Enema on Treatment if Postoperative Inflammatory Intestinal Obstruction[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(17): 76-81. DOI： 10.13422/j.cnki.syfjx.20191533.

摘要

目的：

探讨大承气汤加味灌肠治疗小儿术后炎性肠梗阻(EPISBO)的疗效，及对炎症因子、胃肠动力和肠屏障功能的影响。

方法：

将106例患儿采用随机按数字表法分为对照组52和观察组54例。两组患儿均给予禁食水、胃肠减压、维持水电解质平衡、营养支持等基础治疗。对照组采用注射用生长抑素，0.003 5 mg·h

－1

·kg

－1

，持续微泵泵入，连续3 d；口服醋酸地塞米松片，2.5～5 mg/次，2次/d；合并感染采用注射用头孢他啶，30～100 mg·kg

－1

，分2～3次静脉滴注。观察组基础治疗同对照组，并给予大承气汤加味灌肠，125 mL/次，2次/d。两组疗程均为连续治疗5 d。记录腹胀缓解时间、肠鸣音恢复时间、恢复排气、恢复排便时间和饮食恢复时间；记录住院时间和中转手术情况；进行治疗前后主要胃肠道症状、体征评分；检测治疗前后血清白细胞介素-6(IL-6)，肿瘤坏死因子-

(TNF-

)，超敏C-反应蛋白(hs-CRP)，血管活性肠肽(VIP)，胃泌素，胃动素，二胺氧化酶(DAO)和

-乳酸水平。

结果：

经秩和检验分析，观察组临床疗效优于对照组(

0.05)；观察组胃肠道功能指标(腹胀缓解时间、肠鸣音恢复时间、恢复排气、恢复排便时间、饮食恢复时间)恢复时间均短于对照组(

0.05，

0.01)；观察组平均住院时间短于对照组(

0.01)，两组患儿中转手术率，经确切概率法分析，无统计学差异；观察组血清IL-6，TNF-

和hs-CRP水平均低于对照组(

0.01)；观察组VIP水平低于对照组，胃动素和胃泌素水平均高于对照组(

0.05)；观察组DAO，

-乳酸水平均低于对照组(

0.01)；观察组主要胃肠道症状、体征评分均低于对照组(

0.01)。

结论：

在西医常规治疗的基础上，给予大承气汤加味灌肠治疗小儿EPISBO，能起到抗炎、调节胃肠激素和保护肠屏障功能作用，从而起到改善胃肠动力、减轻症状、缩短病程及提高临床疗效。

Abstract

Objective:

To discuss the clinical efficacy of modified Da Chengqitang by enema in treatment of postoperative inflammatory intestinal obstruction (EPISBO) after the operation and its effect on inflammatory factors

gastrointestinal motility and intestinal barrier function.

Method:

One hundred and six patients were randomly divided into control group (52 cases) and observation group (54 cases) by random number table. Patients in both groups were given fasting for solids and liquids

gastrointestinal decompression

maintaining water and electrolyte balance

nutritional support and other basic therapies. Patients in control group were given somatostatin for injection for continuous micro-pumping

0.003 5 mg·h

-1

·kg

-1

dexamethasone acetate tablets

2.5-5 mg/time

2 time/days. Patients with concurrent infection got ceftazidime for injection

30-100 mg·kg

-1

2-3 intravenous drips. In addition to the therapy of control group

patients in observation group were also given modified Da Chengqitang

125 mL/time

2 times/days. A course of treatment was 5 days. Time of remission of abdominal distention

recovery of exhaust gas

bowel sounds and diet

defecation

hospitalization and transitional surgery were recorded. And main gastrointestinal symptoms and signs were scored. And levels of serum interleukin-6 (IL-6)

tumor necrosis factor-

(TNF-

)

high-sensitivity C-reactive protein (hs-CRP)

vasoactive intestinal peptide (VIP)

gastrin

motilin

diamine oxidase and

lactic acid were detected.

Result:

After treatment

according to rank sum test analysis

the clinical efficacy in observation group was better than that in control group (

0.05). And indicators of gastrointestinal function (abdominal distension relief time

bowel sounds recovery time

recovery of exhaust

defecation time and diet recovery time) were all shorter than those in control group (

0.05

0.01). And average length of stay in observation group was shorter than that in control group (

0.01). According to exact probability analysis

there was no statistical difference in conversion rate between the two groups. And levels of IL-6

TNF-

hs-CRP

VIP

DAO

-lactic acid and scores of main gastrointestinal symptoms and signs were all lower than those in control group (

0.01)

while levels of motilin and gastrin were higher than those in control group (

0.01).

Conclusion:

In addition of routine therapy of western medicine

modified Dachengqi Tang had effects in resisting inflammation

regulating gastrointestinal hormones

and protecting intestinal barrier function

so can improve gastrointestinal motility

alleviate symptoms

shorten the course of disease and improve the clinical efficacy.

关键词

Keywords

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