摘要
目的:观察通腑逐瘀汤保留灌肠温度对急性重症胰腺炎(SAP)患者腹胀腹痛、排便改善效果及血清AMS、LPS的影响。方法:选取92例SAP患者为研究对象,依照区组随机化分组法将其分为对照组30例、常温组31例、实验组31例。对照组采用39-41℃的肥皂水进行灌肠,常温组则在其基础上联合39-41℃常温通腑逐瘀汤进行灌肠治疗,实验组则联合通腑逐瘀汤保留35-38℃灌肠温度进行灌肠治疗。观察三组排便改善效果(肠鸣音恢复时间、首次排气时间、首次排便时间),比较治疗前、治疗1周后三组腹胀、腹痛症状差异、三组血清胰酶水平[血清淀粉酶(AMS)、脂肪酶(LPS)]。结果:三组间肠鸣音恢复时间、首次排气时间、首次排便时间整体差异有统计学意义(P<0.05),实验组肠鸣音恢复时间明显低于常温组、对照组(P<0.05),实验组首次排气时间、首次排便时间明显低于对照组(P<0.05),常温组肠鸣音恢复时间、首次排气时间、首次排便时间明显低于对照组(P<0.05)。治疗1周后,三组腹胀严重程度、腹痛VAS评分、AMS、LPS水平较治疗前均有显著降低(P<0.05),且实验组腹胀严重程度、腹痛VAS评分、AMS、LPS水平均明显低于常温组、对照组(P<0.05),常温组腹胀严重程度、腹痛VAS评分、AMS、LPS水平均明显低于对照组(P<0.05)。结论:通腑逐瘀汤保留灌肠温度能有效缓解SAP患者腹胀腹痛症状,改善排便,促进胰腺恢复,具有较高临床应用价值。
Objective:To observe the effect of Tongfu Zhuyu Decoction retention enema temperature on abdominal distension,abdominal pain,defecation and serum AMS,LPS for patients with severe acute pancreatitis(SAP).Methods:92 patients with SAP were randomly divided into a controlled group(n=30),a normal temperature group(n=31)and an experimental group(n=31).The controlled group was treated with comprehensive treatment of acute pancreatitis,the normal temperature group was treated with 35~38℃Tongfu Zhuyu Decoction for enema,and the experimental group was treated with Tongfu Zhuyu Decoction for enema at 41℃.The defecation improvement effects(bowel sounds recovery time,first exhaust time,first defecation time)of the three groups were observed,and the differences of abdominal distension,abdominal pain symptoms and serum trypsin levels[serum amylase(AMS),lipase(LPS)]of the three groups before treatment and after 1 weeks of treatment were compared.Results:There were significant differences in the recovery time of bowel sounds,the first exhaust time and the first defecation time among the three groups(P<0.05).The recovery time of bowel sounds in the experimental group was significantly lower than that in the normal temperature group and the controlled group(P<0.05).The recovery time of bowel sounds,the first exhaust time and the first defecation time in the experimental group were significantly lower than those in the controlled group(P<0.05).The defecation time in the treatment group was significantly lower than that in the controlled group(P<0.05).After 1 weeks of treatment,the severity of abdominal distension,VAS score of abdominal pain,AMS and LPS levels of the three groups were significantly lower than those before treatment(P<0.05),and the severity of abdominal distension,VAS score of abdominal pain,AMS and LPS levels of the experimental group were significantly lower than those of the normal temperature group and the controlled group(P<0.05),and the severity of abdominal distension,VAS score of abdominal pain,AMS and LPS levels of the normal temperature group were significantly lower than those of the controlled group(P<0.05).Conclusion:The retention enema temperature of Tongfu Zhuyu Decoction can effectively relieve the symptoms of abdominal distension and pain in SAP patients,improve defecation and promote the recovery of pancreas,which has high clinical application value.
作者
刘嘉斌
LIU Jiabin(Department of Integrated Traditional Chinese and Western Medicine,West China Hospital Attached to Sichuan University,West China School of Nursing,Chengdu Sichuan 610041,China)
出处
《四川中医》
2022年第12期219-221,共3页
Journal of Sichuan of Traditional Chinese Medicine
关键词
通腑逐瘀汤
灌肠温度
急性重症胰腺炎
Tongfu Zhuyu Decoction
Enema temperature
Severe acute pancreatitis
