复方大承气汤联合肠梗阻导管治疗恶性肠梗阻的临床研究

目的:研究复方大承气汤联合经鼻型肠梗阻导管对恶性肠梗阻(MBO)的治疗效果、损伤的肠黏膜屏障修复和免疫紊乱的影响.方法:选择2018年7月—2019年8月我院收治的MBO患者30例,随机数表法分成对照组和中药组,各15例,两组均给予常规治疗,对照组在此基础上急症放置经鼻型肠梗阻导管,24 h后开始口服温开水100 mL...

Clinical Study of Compound Dachengqi Decoction Combined with Ileus Tube on the Treatment of Malignant Bowel Obstruction

Objective To study the effect,the repair of damaged intestinal barrier and immune disorders of compound Dachengqi decoction combined with transnasal ileus tube on the treatment of malignant bowel obstruction(MBO).Methods Totally 30 cases of MBO treated in our hospital from July 2018 to August 2019 were studied.The patients were divided into control group(n=15)and the traditional Chinese medicine(TCM)group(n=15)according to random number table method.The patients in two groups were treated with regular treatment.The control group placed the transnasal ileus tube in emergency on this basis and began to take 100ml warm boiled water twice a day for 7 days after 24 hours.On the basis of the control group,the TCM group changed the white boiled water into the oral compound Dachengqi Decoction,taking the same method as the control group.The curative effect,clinical indicators,intestinal barrier damage indicators and immune indicators were compared between the two groups.Results The effective rate of TCM group(86.7%)was significantly higher than that of the control group(53.3%)(P<0.05).The recovery time of exhaust and defecation in TCM group was earlier than that in the control group(P<0.05).For 7 days after placement of transnasal ileus tube,the daily flow of ileus tube in the TCM group was less than that in the control group,especially 4 to 6 days after placement of ileus tube,which the difference was significant difference(P<0.05).Three days after placement of ileus tube,the abdominal plain film was reexamined in the two groups.Most of the patients’gas-liquid plane disappeared and there was no significant difference between the two groups(P>0.05).On the 7th day after treatment,the levels of Diamine oxidase(DAO)and D-lactate(D-LC)in the serum of the two groups decreased,and the level of DAO and D-LC in the TCM group was significantly lower than that in the control group(P<0.05).The levels of IgA,IgG and IgM in the two groups were all increased.The level of IgG in the TCM group was significantly higher than that in the control group(P<0.05).The C3 and C4 were increased in both groups,and the level in the TCM group was significantly higher than that in the control group(P<0.05).The CD3+,CD4+,CD8+were increased in both groups,and the levels of CD3+,CD4+and CD8+in the TCM group were significantly higher than those in the control group(P<0.05).Conclusion Compound Dachengqi Decoction combined with transnasal ileus tube can improve the curative effect of MBO.Compound Dachengqi Decoction can also promote the repair of intestinal mucosal barrier injury of MBO and regulate the immune function disorder of patients with MBO,which is worthy of clinical promotion.