益气解毒通腑法对危重症术后胃肠功能障碍患者胃肠运动及肠黏膜屏障功能的影响

摘要

目的 观察益气解毒通腑法对危重症术后胃肠功能障碍患者胃肠运动及肠黏膜屏障功能的影响.方法 将90例患者按照随机数字表法分为对照组和观察组,各45例,对照组给予常规对症治疗,观察组患者在对照组基础上给予益气解毒通腑方保留灌肠治疗,治疗1、3、7d后观察两组患者的胃肠功能恢复情况、肠黏膜屏障功能和炎症因子水平,观察患者首次肛门排气时间、排便时间.结果 治疗3d和7d后,观察组患者胃肠功能障碍评分显著低于对照组(P<0.05).观察组肛门排气时间和排便时间均显著低于对照组(P<0.05).治疗3 d和7 d后,观察组肠黏膜屏障指标血清二氨氧化酶(DAO)和D-乳酸水平均显著低于对照组(P<0.05).治疗3 d和7 d后,观察组患者的血清C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)水平显著低于对照组(P<0.05).结论 益气解毒通腑法灌肠治疗危重症术后胃肠功能障碍患者具有较好的临床疗效,可促进胃肠运动恢复,改善肠黏膜屏障功能指标,减轻炎症反应因子水平,利于患者康复.%Objective: To study the effect of Yiqi Jiedu Tongfu method on gastrointestinal movement and in-testinal mucosal barrier function of critical patients with postoperative gastrointestinal dysfunction. Methods: 90 critically ill patients with postoperative gastrointestinal dysfunction were divided into the control group (45 cases) and the observation group (45 cases) in the hospital between January 2015 and July 2015 according to random number table method. The control group were given conventional treatment,while the observation group were giv-en retention enema of Yiqi Jiedu Tongfu on the basis of the control group. After 1d,3d,7d treatment,the gastroin-testinal function recovery,intestinal mucous membrane barrier function,inflammatory factor levels,the time of anus exhaust and defecation were observed. Results: After 3 d and 7 d treatment,the score of gastrointestinal dysfunction in the observation group was significantly lower than that of the control group (P<0.05). The time of anus exhaust and defecation in the observation group were significantly lower than those of the control group (P<0.05). After 3 d and 7 d treatment,the levels of intestinal mucosa DAO and serum D-lactic acid were significant-ly lower than control group (P<0.05). After 3 d and 7 d treatment,the levels of serum CRP and TNF-α were significantly lower than those of the control group (P<0.05). Conclusion: Yiqi Jiedu Tongfu method on critical patients with postoperative gastrointestinal dysfunction has a better clinical curative effect,and can promote gastric bowel movement recovery,improve the intestinal mucosal barrier function index,and reduce inflammation factor level,beneficial to recovery.