香砂六君子汤对老年髋关节患者术后肠道功能的影响

目的:探讨香砂六君子汤对老年髋关节患者术后肠道功能的影响。方法:选择2017年3月-2018年8月在我院全麻下行全髋或半髋置换的患者80例,采用随机数字法分为对照组和观察组,每组40例。对照组患者治疗前后采用枳术汤煎服,观察组患者采用香砂六君子汤水煎服。比较两组患者中药治疗前后的肠脂肪酸结合蛋白(I-FABP)、D-乳酸、C反应蛋白(C-reactive Protein,CRP)、降钙素原(Procalcitonin,PCT)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、白细胞介素(Interleukin,IL)-6等指标的变化,比较两组患者术后肠鸣音恢复时间、术后首次排气时间、术后首次排便时间,并比较两组患者治疗期间的不良反应发生情况。结果:两组患者术后1天的I-FABP和D-乳酸水平较术前1天有所升高(P<0.05或P<0.01),两项指标在术后3 d和7 d的水平较术前降低(P<0.001),观察组患者术后3 d的I-FABP和D-乳酸水平较对照组低(P<0.05或P<0.001);两组患者术后1天的CRP、PCT、TNF-α、IL-6指标水平较术前1天有所升高(P<0.001),各项指标在术后7天的水平较术前降低(P<0.001),观察组患者术后3 d各项指标水平较对照组低(P<0.05或P<0.01);观察组患者肠鸣音恢复时间、首次排气时间和首次排便时间均短于对照组(P<0.05或P<0.01)。结论:香砂六君子汤可以早期减轻老年患者髋关节术后肠道功能障碍,降低炎性反应,缓解肠道功能异常症状。

Efficacy of the Xiangsha Liujunzi decoction on intestinal function in elderly patients after hip joint surgery

Objective:To explore efficacy of the Xiangsha Liujunzi decoction(香砂六君子汤)on postoperative intestinal function in elderly hip patients.Methods:Eighty patients with total hip arthroplasty or hemiarthroplasty under general anesthesia from March 2017 to August 2018 were randomly divided into the control group and the observation group,40 cases in each.The control group was treated with the Zhizhu decoction(枳术汤),and the control group was treated with the Xiangsha Liujunzi decoction.Results:The levels of I-FABP and D-lactic acid in two groups on the first day after surgery were higher than that before surgery(P﹤0.05 or P﹤0.01)and were lower on 3 and 7 days after surgery than that before surgery(P﹤0.001).The I-FABP and D-lactic acid levels in the observation group were lower than the control group on 3 days after surgery(P﹤0.05 or P﹤0.001).The levels of CRP,PCT,TNF-α,and IL-6 in two groups on the first day after surgery were higher than that before surgery(P﹤0.001),and were lower on 3 and 7 days after surgery than that before surgery(P﹤0.001).The levels of CRP,PCT,TNF-αand IL-6 in the observation group were lower than the control group on 3 days after surgery(P﹤0.05 or P﹤0.01).The recovery time of bowel sounds,first exhaust time and first defecation time in the observation group were shorter than those in the control group(P﹤0.05 or P﹤0.01).Conclusion:The Xiangsha Liujunzi decoction can early relieve intestinal dysfunction after hip surgery in elderly patients,reduce inflammatory reaction,alleviate intestinal dysfunction.