通腑承气汤对术后早期炎症性肠梗阻患者血清炎性因子及胃肠功能康复的影响

目的:探讨应用中药通腑承气汤加减方治疗术后早期炎症性肠梗阻的临床疗效。方法:选取本院胃肠外科2018年3月—2020年3月84例术后早期炎症性肠梗阻患者,随机分为常规组与中药组,每组42例。对比两组疗效、胃肠功能康复与不良反应及治疗前后血清炎性因子指标超敏C反应蛋白(hsCRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、降钙素原(PCT)]。结果:治疗后,中药组临床总疗效88.10%(37/42),显著高于常规组71.43%(30/42),常规组和中药组通腑承气汤组肠鸣音恢复、腹部症状(腹痛腹胀)消失、肛门排气与胃管撤离时间分别为(3.56±0.87)d vs(2.14±0.43)d、(5.79±1.02)d vs(3.58±0.84)d、(4.69±1.10)d vs(3.05±0.97)d、(6.43±1.78)d vs(4.09±1.12)d,差异有统计学意义(P<0.05);常规组与中药组不良反应总发生率分别为4.76%(2/42)、7.14%(3/42),差异无统计学意义(P>0.05)。治疗前,两组血清hsCRP、TNF-α、IL-8与PCT水平差异均无统计学意义(P>0.05);治疗后,中药组血清hsCRP、TNF-α、IL-8与PCT水平均低于常规组,分别为(30.43±8.76)vs(61.26±11.32)mg/L、(24.75±9.86)vs(43.07±12.14)ng/mL、(67.64±21.32)vs(98.77±28.96)pg/mL、(70.06±15.34)vs(125.63±19.48)pg/mL,差异有统计学意义(P<0.05)。结论:临床上将中药通腑承气汤用于术后早期炎症性肠梗阻患者,不仅可缩短患者胃肠功能康复所需的时间与减轻炎性反应,提高临床疗效,且不良反应未见明显增多,安全性尚可,有一定的临床使用及推广价值。

Effects of Tongfu Chengqi Decoction on Serum Inflammatory Factors and Gastrointestinal Function Recovery in Patients with Early Postoperative Inflammatory Bowel Obstruction

Objective To investigate the effects of Tongfu Chengqi plus or minus decoction on the clinical efficacy and adverse reactions of patients with early postoperative inflammatory bowel obstruction.Methods Eighty-four patients with early postoperative inflammatory bowel obstruction from March 2018 to March 2020 in our hospital were divided into a conventional group(routine treatment of inflammatory bowel obstruction by Western medicine)and Tongfu Chengqi decoction group(conventional treatment plan with addition or subtraction of Tongfu Chengqi Decoction)according to the random number table method,which 42 cases in each group.The curative effect,gastrointestinal function recovery and adverse reactions of the two groups after treatment,and serum inflammatory factor indicators before and after treatmentSupersensitive C-reactive protein(hsCRP),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),procalcitonin(PCT)]were compared.Results After treatment,the total clinical efficacy of Tongfu Chengqi decoction group was 88.10%(37/42),which significantly higher than that of the conventional group 71.43%(30/42).Recovery time of song,time of disappearance of abdominal symptoms(abdominal pain and bloating),time of anal exhaust and gastric tube evacuation were longer than those of Tongfu Chengqi decoction group(3.56±0.87)vs(2.14±0.43)d,(5.79±1.02)vs(3.58±0.84)d,(4.69±1.10)vs(3.05±0.97)d,(6.43±1.78)vs(4.09±1.12)d and there are differences in comparison(P<0.05).The total incidence of adverse reactions in the conventional group and the Tongfu Chengqi decoction group was 4.76%(2/42),7.14%(3/42),which no difference in comparison(P>0.05).Before treatment,there was no difference in serum hsCRP,TNF-α,IL-8 and PCT levels between the two groups(P>0.05).After treatment,the levels of serum hsCRP,TNF-α,IL-8 and PCT in Tongfu Chengqi decoction group were lower than those of the conventional group(30.43±8.76)vs(61.26±11.32)mg/L,(24.75±9.86)vs(43.07±12.14)ng/mL,(67.64±21.32)vs(98.77±28.96)pg/mL,(70.06±15.34)vs(125.63±19.48)pg/mL and there are differences in comparison(P<0.05).Conclusion The clinical application of Tongfu Chengqi decoction in patients with early postoperative inflammatory bowel obstruction can not only shorten the time required for the recovery of gastrointestinal function and alleviate inflammatory reactions,but also improve clinical efficacy.Significantly increased,the safety is acceptable,and it has certain clinical usage and promotion value.