中药灌肠、外敷、针刺对粘连性肠梗阻患者炎性因子TNF-α、IL-6的影响

目的:观察中药灌肠、外敷、针刺配合常规治疗方法对粘连性肠梗阻患者炎性因子的影响。方法:将60例患者随机分为两组。A组(对照组)28例,采用胃肠减压、抗感染及支持疗法的西医保守治疗方法;B组(治疗组)32例,在A组治疗基础上结合通腑泻热合剂保留灌肠同时用双柏散外敷腹部疼痛部位及针刺足三里。观察两组临床疗效和治疗前后TNF-α(肿瘤坏死因子)、IL-6(白细胞介素-6)前后水平变化。结果:两组治疗后TNF-α、IL-6水平均降低,其中治疗组降低更显著(与对照组比较,P<0.05);治疗组患者腹痛消失时间、肛门排气、排便时间、X线气液平面消失时间与对照组比较均缩短,差异均有非常显著性意义(P<0.05)。结论:中西医结合治疗粘连性肠梗阻疗效优于单纯西医常规治疗,运用外治法能降低粘连性肠梗阻患者血中TNF-α、IL-6水平,具有免疫调节、减轻炎症反应从而提高临床疗效的作用。

Effects of Traditional Chinese Medicine Enema External Application and Acupuncture on Inflammatory Factors of TNF-α and IL-6 of Patients with Adhesive Intestinal Obstruction

Objective:To observe the effects of combining traditional Chinese medicine enema,external application,acupuncture with conventional treating methods on the inflammatory factors of patients with adhesive intestinal obstruction.Methods:60 patients were divided into two groups at random.Group A(control group)was formed by 28 cases of patients,and the conservative western medicine treatment methods such as gastrointestinal decompression,resistance to infection and supportive therapy are adopted;B group(treatment group)was formed by 32 cases of patients.In addition to the treating methods for group,the traditional Chinese medicine retention enema was adopted.Meanwhile,the Shuangbai powder(a kind of powder made of several traditional Chinese medicine)was applied to the painful location on the abdomen,and the acupuncture point of Zusanli was treated with the needles.The clinical efficacy and the changes of TNF-α(tumor necrosis factor)and IL-6(interleukin-6 level)before and after the treatment of both groups were observed.Results:After treatment,TNF-α and IL-6 of both groups were decreased.The treatment group was decreased more significantly(P<0.05,compared with the control group).The patients in the treatment group spent less time on the disappearance of abdominal pains,the exhausting and defecation of the anal,the disappearance of X ray of gas-liquid level than those the control group,such differences were significant(P<0.05).Conclusion:The curative effect of adhesive intestinal obstruction by combining the traditional Chinese medicine with the western medicine treatment was better than that of the conventional western medicine therapy.The external therapy could reduce the TNF-α and IL-6 levels in the blood of patients with adhesive intestinal obstruction,resulting in immune regulation,inflammation relief and improvement of the clinical efficacy.