世界中医药

作者	单位
陈锡钧1，洪健1，曾碧城2，黄楚忠2	1 南方医科大学中西医结合医院外二科，广州，510000； 2 东莞市常平医院普外科,东莞,523560

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中文摘要:

目的：探讨大建中汤对腹部手术后患者胃肠功能调理的效果观察。方法：选取2012年11月至2014年11月在东莞市常平医院行经腹部手术患者165例，将其随机分为观察组86例和对照组79例，对照组在常规治疗的基础上给予多潘立酮片，观察组在对照组基础上给予大建中汤加味治疗，2组连续治疗5 d后进行疗效评价，比较2组患者术后胃肠功能恢复时间、血浆胃动素（MOT）水平、T细胞亚群变化以及术后肠粘连发生情况。结果：观察组患者术后肠鸣音恢复时间、胃肠减压时间以及自然排气时间均显著低于对照组，差异有统计学意义（P<0.05）；治疗前2组患者血浆MOT水平无显著差异（P>0.05），治疗后2组患者血浆MOT水平显著升高（P<0.05），且治疗后观察组患者血浆MOT水平显著高于对照组（P<0.05）；治疗前2组患者T细胞亚群无显著差异（P>0.05），治疗后2组患者T细胞亚群均明显改善（P<0.05），且观察组改善程度显著优于对照组（P<0.05）；观察组患者术后肠粘连发生率显著低于对照组（P<0.05）。结论：大建中汤加减对腹部手术患者胃功能有明显的促进作用，可调整患者术后的应激状态，保持患者内环境的稳定，提高患者机体免疫功能，从而促进患者术后胃肠功能的紊乱，有助于患者术后康复以及提高患者生命质量。

English Summary:

To investigate the effects of dajianzhong decoction in regulating gastrointestinal function after abdominal surgery. Methods:A total of 165 cases who underwent abdominal surgery in our hospital from November 2012 to November 2014 were randomly divided into observation group of 86 cases and the control group of 79 cases. The control group was given Domperidone Tablets based on conventional treatment, and the observation group was given dajianzhong decoction on the basis of control group. Curative effects were evaluated after continuous treatment for 5 days. Gastrointestinal function recovery time after operation, plasma motilin level, T cell subsets and postoperative intestinal adhesion were compared between two groups. Results:The postoperative bowel sound recovery time, the time of gastrointestinal decompression and natural exhaust time of the observation group were significantly shorter than the control group, and the difference was statistically significant (P<0.05). The level of MOT in two groups had no significant difference before treatment (P>0.05), and plasma MOT levels of two groups increased significantly after treatment (P<0.05). After treatment, plasma MOT level of observation group was significantly higher than the control group (P<0.05). Before treatment, there was no significant difference between the two groups in T cell subsets (P>0.05), after treatment, the T cell subsets in the two groups were significantly improved (P<0.05), and the improvement of the observation group was significantly better than that of the control group (P<0.05). The incidence of postoperative intestinal adhesions in the observation group was significantly lower than that in the control group (P<0.05). Conclusion:Dajianzhong decoction has significant effects on promoting the function of the stomach in patients with abdominal surgery, can adjust the postoperative stress state, maintain the stability of internal environment, improve the immune function of patients, so as to improve the gastrointestinal function, and contribute to postoperative rehabilitation and improve the quality of life.

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