穴位贴敷联合中药灌肠促进腹腔镜胆囊切除术后胃肠功能恢复临床研究

Clinical study of acupoint application combined with Chinese medicine clysma to promote gastrointestinal function recovery after laparoscopic cholecystectomy

关键词:  腹腔镜胆囊切除术  穴位贴敷  中药灌肠  胃肠功能紊乱

Key words:  laparoscopic cholecystectomy  acupoint application  Chinese medicine clysma  gastrointestinal dysfunction

摘要:

[目的] 探讨穴位贴敷联合中药灌肠促进腹腔镜胆囊切除术（LC）后胃肠功能恢复的临床效果。[方法] 选择2021年6月—2022年12月期间于秦皇岛市中医医院外科接受LC手术的良性胆囊疾病患者96例，按照随机数字表法分为观察组和对照组，各48例。对照组术后接受西医常规治疗，包括氧气吸入、生命体征监护，并予以维持水、电解质平衡、抗感染等，并于术后8 h开始予以中药通腑汤保留灌肠。观察组在此基础上予以穴位贴敷。比较两组肠鸣音恢复时间、首次排气时间和首次排便时间；比较两组术后第1、5天腹部胀痛评分、胃肠反应评分及血清生长抑素（SS）、血管活性肠肽（VIP）水平，并比较两组治疗总有效率。[结果] 观察组肠鸣音恢复时间、首次排气时间和首次排便时间均少于对照组（P<0.01）；术后第5天腹部胀痛评分、胃肠反应评分低于对照组（P<0.01），血清SS、VIP水平低于对照组（P<0.01），治疗总有效率高于对照组（P<0.05），差异均有统计学意义。[结论] 穴位贴敷联合中药灌肠可降低腹部胀痛评分和胃肠反应评分，改善血清SS、VIP，促进胃肠功能恢复，治疗LC术后胃肠功能紊乱效果显著。

Abstract:

[Objective] To investigate the clinical effect of acupoint application combined with Chinese medicine clysma on gastrointestinal function recovery after laparoscopic cholecystectomy（LC）. [Methods] The 96 patients with benign gallbladder disease who received LC in the department of surgery of our hospital from June 2021 to December 2022 were selected and divided into observation group and control group according to the random number table method，with 48 patients in each group. The control group received conventional Western medicine treatment after surgery，including oxygen inhalation，vital signs monitoring，water and electrolyte balance maintenance，anti-infection，etc. The retention enema of Tongfu Decoction was given at 8 hours after operation. The observation group was given acupoint application on this basis. Bowel sound recovery time，first exhaust time and first defecation time were compared between the two groups. Abdominal distension and pain scores，gastrointestinal reaction scores，serum somatostatin （SS） and vasoactive intestinal peptide（VIP） levels on day 1 and day 5 after surgery were compared between the two groups，and the total effective rate was compared between the two groups. [Results] The recovery time of bowel sound，first exhaust time and first defecation time of the observation group were less than those of the control group （P<0.01）. The abdominal pain score and gastrointestinal reaction score on the 5th day after surgery were lower than those of the control group （P<0.01），the serum SS and VIP levels were lower than those of the control group （P<0.01），and the total effective rate was higher than that of the control group （P<0.05），the differences were statistically significant. [Conclusion] Acupoint application combined with Chinese medicine clysma can reduce abdominal distension pain score and gastrointestinal reaction score，improve serum SS and VIP，promote gastrointestinal function recovery，and it has a significant effect in the treatment of gastrointestinal dysfunction after LC.