补中益气汤联合耳穴埋籽对妇科腹腔镜手术患者术后炎症反应及胃肠功能恢复的影响

Effects of Buzhong Yiqi Decoction combined with auricular acupuncture point seed burial on postoperative inflammatory response and gastrointestinal function recovery in gynecologic laparoscopic surgery patients

关键词:  补中益气汤  腹腔镜手术  耳穴埋籽  巨噬细胞集落刺激因子

Key words:  Buzhong Yiqi Decoction  laparoscopic surgery  ear acupoint seed implantation  granulocyte-macrophage colony-stimulating

摘要:

[目的] 探究补中益气汤联合耳穴埋籽对妇科腹腔镜手术患者术后炎症反应及胃肠功能恢复的影响。[方法] 选取2022年6月—2024年6月进行妇科腹腔镜手术的患者200例作为研究对象，随机分为对照组（50例）、补中益气汤组（50例）、耳穴埋籽组（50例）和联合组（50例）。比较各组患者胃肠功能改善情况、巨噬细胞集落刺激因子（GM-CSF）、超敏C反应蛋白（hs-CRP）、免疫功能、镇痛效果、心理状态和腹胀发生情况。[结果] 联合组患者的肠鸣音恢复时间、肛门排气时间、手术时间、进食恢复时间、住院时间均低于耳穴埋籽组、补中益气汤组和对照组（P<0.05）。耳穴埋籽组、补中益气汤组和联合组患者治疗7 d后的GM-CSF、hs-CRP水平、汉密顿焦虑量表（HA-MA）和汉密顿抑郁量表（HAMD）量表评分较治疗前均显著降低，且联合组显著低于耳穴埋籽组和补中益气汤组（P<0.05）。耳穴埋籽组、补中益气汤组和联合组患者治疗7 d后的免疫球蛋白A（IgA）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）水平显著提高，且联合组显著高于耳穴埋籽组和补中益气汤组（P<0.05）。耳穴埋籽组、补中益气汤组和联合组患者治疗7 d后疼痛视觉模拟量表（VAS）评分较治疗前均显著降低，且联合组显著低于耳穴埋籽组和补中益气汤组（P<0.05）。联合组患者的腹胀发生率（6.00%）显著低于耳穴埋籽组（20.00%）、补中益气汤组（20.00%）和对照组（28.00%）。[结论] 采用补中益气汤联合耳穴埋籽对妇科腹腔镜手术患者，可以降低GM-CSF、hs-CRP水平，改善胃肠功能，提高免疫能力，缓解镇痛和焦虑抑郁情绪，降低腹胀发生率。

Abstract:

[Objective] To investigate the effect of Buzhong Yiqi Decoction combined with auricular acupuncture point seed burial on to postoperative inflammatory response and gastrointestinal function recovery in gynecologic laparoscopic surgery patients. [Methods] Two hundred patients who underwent gynecological laparoscopic surgery from June 2022 to June 2024 were selected as the study subjects and randomly divided into the control group（50 cases），the Buzhong Yiqi Decoction group（50 cases），the auricular acupuncture point burying seeds group（50 cases） and the combined group（50 cases）. Improvement of gastrointestinal function，macrophage colony-stimulating factor（GM-CSF），ultrasensitive C-reactive protein（hs-CRP），immune function，analgesic effect，psychological state and occurrence of abdominal distension were compared among the four groups. [Results] The recovery time of bowel sounds，anal defecation time，operation time，feeding recovery time，and hospitalization time of the patients in the combined group were lower than those in the auricular acupuncture point seed burial group，the Buzhong Yiqi Decoction group，and the control group（P<0.05）. The GM-CSF，hs-CRP levels，Hamilton anxiety scale（HA-MA） and Hamilton depression scale（HAMD） scores of the patients in the auricular acupuncture point seed group，the Buzhong Yiqi Decoction group and the combined group were significantly lower than those of the patients in the auricular acupuncture point seed group and the Buzhong Yiqi Decoction group（P<0.05） after 7 d of treatment. Immunoglobulin A（IgA），immunoglobulin G（IgG），and immunoglobulin M（IgM） levels of the patients in the auricular seed burrowing group，the tonic medium and beneficial qi soup group，and the combined group were significantly higher than those in the auricular seed burrowing group and the tonic medium and Buzhong Yiqi Decoction group after 7 d of treatment（P<0.05）. The VAS scores of the patients in the auricular acupuncture point seed burial group，the Buzhong Yiqi Decoction group and the combined group were significantly lower than those before treatment after 7 d of treatment，and the combined group was significantly lower than the auricular acupuncture point seed burial group and the Buzhong Yiqi Decoction group（P<0.05）. The incidence of abdominal distension in patients in the combined group（6.00%） was significantly lower than that in the auricular acupuncture point seed burial group（20.00%），the Buzhong Yiqi Decoction group（20.00%） and the control group（28.00%）. [Conclusion] The Buzhong Yiqi Decoction combined with ear acupoint seed implantation can reduce GM-CSF and hs-CRP levels，improve gastrointestinal function，enhance immune function，alleviate pain and anxiety，and reduce the incidence of abdominal distension in patients undergoing gynecological laparoscopic surgery.