保和汤联合穴位贴敷促进胃癌术后肠蠕动恢复的临床研究(1)
[摘要] 目的 探讨保和汤联合穴位贴敷对胃癌术后肠蠕动恢复的作用。 方法 选择2014年8月～2015年2月在我院腹部外科行全胃切除术的62例胃癌患者，对照组31例采用常规护理方法；观察组31例则在常规护理方法的基础上，加用鼻饲保和汤、联合生大黄穴位贴敷的护理方法。观察两组患者术后胃管拔除的时间、首次肛门排气和排便时间以及腹痛腹胀发生率等。 结果 观察组胃管拔除时间明显早于对照组[(2.74±0.69)d vs(3.61±1.07)d，t=-2.131，P=0.037)]；观察组肛门首次排气时间[(74.87±23.9)h vs (94.87±20.92)h，t=-3.502， P=0.001)]和首次排便时间[(5.68±1.48)d vs (6.45±1.22)d，t=-2.241，P=0.029)]明显早于对照组；观察组腹痛腹胀发生率明显低于对照组(16.12% vs 41.93%，χ2=5.010，P=0.025)。 结论 保和汤联合穴位贴敷可有效促进胃癌术后肠蠕动恢复。
[关键词] 胃癌；保和汤；穴位贴敷；肠蠕动功能
[中图分类号] R735.2 [文献标识码] B [文章编号] 1673-9701(2015)31-0107-04
Clinical study on the recovery of intestinal peristalsis treated with Baohe decoction and acupoint sticking in postoperative patient with gastric cancer
XU Yingping LIU Hongqin SHENG Huaying YANG Fang
Department of Abdominal Surgery， Zhejiang Cancer Hospital， Hangzhou 310022， China
[Abstract] Objective To investigate the efficacy of Baohe decoction combined with acupoint on the recovery of intestinal peristalsis in patient with postoperative gastric cancer. Methods A total of 62 cases with gastric cancer with total gastrectomy in the department of surgery in our hospital from August 2014 to February 2015 were enrolled in the study. The patient received routine nursing care in control group， and treated with Baohe decoction and Chinese medicine acupoint in the study group. Postoperative extubation time， anal exhaust time， defecation time were compared between in two groups. Results Extubation time in study group was significantly less than that in control group [(2.74±0.69) d vs (3.61±1.07) d， t=-2.131， P=0.037]. The anal exhaust time [(74.87±23.9) h vs (94.87±20.92) h， t=-3.502， P=0.001] and defecation time [(5.68±1.48) d vs (6.45±1.22) d， t=-2.241， P=0.029] in study group was significantly less than those in control group. The rate of abdominal pain in study group was lower than that in control group (16.12% vs 41.93%， χ2=5.010， P=0.025). Conclusion Baohe decoction combined with acupoint application can promote intestinal peristalsis recovery in postoperative patient with gastric cancer.
[Key words] Gastric cancer； Baohe decoction； Acupoint application； Intestinal peristalsis
全胃切除术后患者一般于术后12～24 h内肠蠕动完全消失[1]，随术后时间延长而渐恢复，开始出现排气或排便。若超过72 h仍不能自主排气排便，则会引起腹胀、腹痛[2]。如何有效安全地缩短术后肠道第一次排气的时间、恢复肠蠕动是术后患者必须解决的难题，亦是减少术后并发症、促进机体康复的重要环节[3]。曾有文献报道保和汤对缓解粘连性肠梗阻及食滞胃脘痛具有积极作用。保和汤的功能为消食导滞，和胃止痛；行气通腑，理气消胀化瘀，可迅速加快肠道肠蠕动功能的恢复[4]，减少肠腔内有害物质的产生，减少并消除腹胀、腹痛，同时泻下作用可使细菌毒素及其他有害物质尽快排除体外，从而消除导致梗阻的病理因素[5]。因此，为促进胃癌患者术后肛门排气或排便功能的尽早恢复，预防术后腹痛腹胀的发生，我们在2014年8月～2015年2月期间对胃癌术后患者进行保和汤联合穴位贴敷法促进术后肠蠕动恢复的研究，取得较好的效果，现报道如下。, http://www.100md.com(徐英萍 刘鸿芹 盛华英 杨芳)
[关键词] 胃癌；保和汤；穴位贴敷；肠蠕动功能
[中图分类号] R735.2 [文献标识码] B [文章编号] 1673-9701(2015)31-0107-04
Clinical study on the recovery of intestinal peristalsis treated with Baohe decoction and acupoint sticking in postoperative patient with gastric cancer
XU Yingping LIU Hongqin SHENG Huaying YANG Fang
Department of Abdominal Surgery， Zhejiang Cancer Hospital， Hangzhou 310022， China
[Abstract] Objective To investigate the efficacy of Baohe decoction combined with acupoint on the recovery of intestinal peristalsis in patient with postoperative gastric cancer. Methods A total of 62 cases with gastric cancer with total gastrectomy in the department of surgery in our hospital from August 2014 to February 2015 were enrolled in the study. The patient received routine nursing care in control group， and treated with Baohe decoction and Chinese medicine acupoint in the study group. Postoperative extubation time， anal exhaust time， defecation time were compared between in two groups. Results Extubation time in study group was significantly less than that in control group [(2.74±0.69) d vs (3.61±1.07) d， t=-2.131， P=0.037]. The anal exhaust time [(74.87±23.9) h vs (94.87±20.92) h， t=-3.502， P=0.001] and defecation time [(5.68±1.48) d vs (6.45±1.22) d， t=-2.241， P=0.029] in study group was significantly less than those in control group. The rate of abdominal pain in study group was lower than that in control group (16.12% vs 41.93%， χ2=5.010， P=0.025). Conclusion Baohe decoction combined with acupoint application can promote intestinal peristalsis recovery in postoperative patient with gastric cancer.
[Key words] Gastric cancer； Baohe decoction； Acupoint application； Intestinal peristalsis
全胃切除术后患者一般于术后12～24 h内肠蠕动完全消失[1]，随术后时间延长而渐恢复，开始出现排气或排便。若超过72 h仍不能自主排气排便，则会引起腹胀、腹痛[2]。如何有效安全地缩短术后肠道第一次排气的时间、恢复肠蠕动是术后患者必须解决的难题，亦是减少术后并发症、促进机体康复的重要环节[3]。曾有文献报道保和汤对缓解粘连性肠梗阻及食滞胃脘痛具有积极作用。保和汤的功能为消食导滞，和胃止痛；行气通腑，理气消胀化瘀，可迅速加快肠道肠蠕动功能的恢复[4]，减少肠腔内有害物质的产生，减少并消除腹胀、腹痛，同时泻下作用可使细菌毒素及其他有害物质尽快排除体外，从而消除导致梗阻的病理因素[5]。因此，为促进胃癌患者术后肛门排气或排便功能的尽早恢复，预防术后腹痛腹胀的发生，我们在2014年8月～2015年2月期间对胃癌术后患者进行保和汤联合穴位贴敷法促进术后肠蠕动恢复的研究，取得较好的效果，现报道如下。, http://www.100md.com(徐英萍 刘鸿芹 盛华英 杨芳)