加味承气汤保留灌肠联合电针治疗术后早期炎性肠梗阻

摘要

目的：探讨一种安全有效的治疗术后早期炎性肠梗阻（EPISBO）的方法。方法：共观察60例EPISBO患者。A组30例，单纯运用西医治疗；B组30例，在西医治疗基础上加用加味承气汤保留灌肠联合电针治疗。结果：A组总有效率86.7%， B组总有效率93.3%，二组患者治疗总有效率差异有统计学意义（P＜0.05）。A组与B组的平均肠鸣音恢复时间分别为（8.6±2.5）d、（6.5±3.1）d，平均肛门排气时间分别为（9.4±3.5）d、（7.1±3.2）d，B组明显优于A组。B组较A组血WBC、CRP治疗后下降明显,差异有统计学意义（P＜0.05）；同时B组较A组血ALB治疗后上升明显（P＜0.05）。二组血清TNF-α、IL-6治疗后较治疗前下降，差异有统计学意义（P＜0.05），且B组较A组下降明显（P＜0.05）；二组血清IL-10治疗后较治疗前上升，且B组较A组上升明显（P＜0.05）。结论：加味承气汤联合电针治疗EPISBO可缩短疗程，减少促炎因子的释放，促进抗炎因子的分泌，减轻肠壁水肿，减少血浆蛋白的丢失，促进肠功能的恢复，提高疗效，效果显著。%Objective To search for a economical, safe and effective treatment method for early postopera-tive inflammatory small bowl obstruction(EPISBO). Methods Total 60 patients observed with EPISBO were randomized into two groups. Group A was western medicine alone treatment group (30 cases). Group B was the combined treatment group of modified Chengqi decoction retention enema joining electro-acupuncture besides western medicine (30 cases). Results The total efficiency of group A was 86.7%, group B was 93.3%, there were significant differences between the two groups(P<0.05).The average recovery time of bowel sound was (8.6 ± 2.5)days in group A and(6.5 ± 3.1)days in group B, the mean anus exhaust time was(9.4 ± 3.5)days in group A and(7.1±3.2)days in group B, group B was more effective than group A. The level of serum WBC、CRP decreased more after treatment in group B than in group A, the differences was statically sig- nificant(P<0.05);and the level of serum ALB increased more after treatment in group B than in group A(P<0.05). In two groups the levels of serum TNF-α, IL-6 were dropped after treatment, and group B was dropped significantly than group A(P<0.05). The level of serum IL-10 was increased after treatment in two groups, and group B was increased significantly than group A(P<0.05). Conclusion The combined application of modified Chengqi decoction retention enema joining electro-acupuncture in treatment of EPISBO embodies the characteristics of traditional Chinese and western medicine. It can shorten the course of treatment, inhibit the re-lease of pro inflammatory cytokines and promote anti inflammatory cytokines secretion. It can relieve edema of intestinal wall,reduce the loss of plasma protein. The recovery of gastrointestinal function is promoted, the effec-tiveness of treatment is improved, and the treatment effect is also satisfied.