不同剂量大承气汤灌肠联合大剂量皮硝外敷治疗肠梗阻的临床观察

目的]观察不同剂量大承气汤灌肠联合大剂量皮硝腹部外敷在肠梗阻患者治疗中的临床疗效。方法] 2014年8月——2017年8月间,将明确诊断为单纯性肠梗阻的病人90例,按随机数字表法分为3组,对照组30例采用禁食、胃肠减压、抗感染、减少胃肠道分泌、灌肠等传统治疗方法,常规剂量组30例在传统治疗基础上灌肠改为常规剂量大承气汤,联合500 g皮硝每日腹部外敷;双倍剂量组30例则在常规治疗基础上将大承气汤用量加倍。结果]双倍剂量组的腹胀腹痛症状减轻时间、恢复肛门排气排便时间均较短,与常规剂量组、对照组比较有统计学差异(P0.05),双倍剂量组、常规剂量组的住院时间较短,与对照组比较有统计学差异(P0.05);双倍剂量组的24 h、3 d的有效率较高,与常规剂量组、对照组比较有统计学差异(P0.05),双倍剂量组、常规剂量组的5 d有效率与对照组比较有统计学差异(P0.05)。结论]不同剂量大承气汤灌肠联合皮硝外敷在单纯性肠梗阻的治疗中均有较好的效果,并且较高剂量的大承气汤临床效果更显著,可在临床治疗中灵活应用。

Clinical observation on treatment of intestinal obstruction with different dosage of Dachengqi Decoction with additions enema combined with large dosage of glauber's salt applied topically

Objective] To observe the clinical effect of different doses of Dachengqi Decoction with additions enema combined with large dosage of glauber''s salt applied topically on the treatment of patients with intestinal obstruction.Methods] From August 2014 to August 2017, 90 patients with a simple diagnosis of simple intestinal obstruction were divided into three groups according to the random number table method. In the control group, 30 patients were treated with fasting, gastrointestinal decompression, anti-infection, reducing gastrointestinal secretion, enema and other traditional treatment methods. Conventional dose group of 30 cases of traditional treatment based on the enema to our regular dose of Dachengqi Decoction; combined with 500 g glauber''s salt applied topically on abdominal daily; double dose group of 30 cases In the conventional treatment based on the amount of Dachengqi Decoction double.Results] In the double-dose group, the time to relieve abdominal distension and abdominal pain, and the time to recover anal exhaust and defecation were shorter, which were statistically different from the conventional dose group and the control group (P<0.05), and the hospitalization in the double-dose group and the conventional-dose group. The time was shorter, compared with the control group (P<0.05); the double-dose group was more effective at 24 hours and 3 days, compared with the conventional dose group and the control group (P<0.05), the 5-day effective rate of the double-dose group and the conventional dose group was statistically different from the control group (P<0.05).Conclusion] Different doses of Dachengqi Decoction enema combined with external application of glauber''s salt in the treatment of simple intestinal obstruction has a good effect, and higher doses of Dachengqi Decoction clinical effect is more significant, flexible application in clinical treatment.