“通腑除满法”针刺治疗腹部手术后胃瘫综合征的临床研究

发布时间：2018-01-03 20:45

本文关键词：“通腑除满法”针刺治疗腹部手术后胃瘫综合征的临床研究　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的观察"通腑除满法"针刺对腹部手术后胃瘫综合征患者血清胃动素影响,探讨针刺促胃排空的作用机制。方法前瞻性随机对照研究。从2016年1月至2016年12月于福建医科大学附属协和医院行腹部手术的患者中,选取符合纳入标准的60例术后胃瘫综合征患者并随机分为2组,对照组采用甲氧氯普胺药物治疗,试验组采用针刺治疗。分别于治疗前后观察胃肠动力恢复的时间、平均胃瘫主要症状指数总分及整个治疗过程中胃肠引流量的变化,并采用双抗体夹心酶联免疫吸附法检测两组患者血清胃动素水平的变化。所有关于统计分析的数据均采用SPSS 20.0软件处理分析:年龄、胃肠动力恢复时间、平均胃肠引流量及胃瘫分级采用两独立样本t检验或秩和检验;性别、原发病类型用四格表卡方检验或RXC列联表卡方检验;两组间平均胃瘫主要症状指数总分和血清胃动素水平的比较采用两独立样本t检验或秩和检验,组内比较采用配对样本t检验或秩和检验。结果1、一般资料分析:治疗前两组患者的年龄、性别、原发病类型及胃瘫分级进行比较,差异无统计学意义(P0.05)。2、胃肠动力恢复时间:两组患者胃肠动力恢复时间比较,差异有统计学意义(P0.05)。3、平均胃瘫主要症状指数总分:两组治疗前后平均胃瘫主要症状指数总分比较,差异有统计学意义(P0.05);两组治疗后平均胃瘫主要症状指数总分比较,差异有统计学意义(P0.05)。4、平均胃肠引流量:两组患者平均胃肠引流量比较,差异有统计学意义(P0.05);5、血清胃动素水平:两组治疗前后血清胃动素水平比较,差异有统计学意义(P0.05);两组治疗后血清胃动素水平比较,差异有统计学意义(P0.05)。结论1、"通腑除满法"针刺和甲氧氯普胺均能改善腹部手术后胃瘫综合征患者的临床症状,减少胃肠引流量和缩短治疗天数,且"通腑除满法"针刺在改善临床症状、减少胃肠引流量和缩短治疗天数方面优于甲氧氯普胺。2、"通腑除满法"针刺和甲氧氯普胺均能增加血清胃动素的水平,且"通腑除满法"针刺的作用优于甲氧氯普胺。3、"通腑除满法"针刺在治疗术后胃瘫综合征更有优势,其机制可能与促进血清胃动素的分泌有关。
[Abstract]:Objective to observe the effect of acupuncture on serum motilin in patients with gastroparesis syndrome after abdominal operation. To explore the mechanism of acupuncture in promoting gastric emptying. Methods A prospective randomized controlled study was conducted in patients undergoing abdominal surgery from January 2016 to December 2016 in Union Hospital affiliated to Fujian Medical University. Sixty patients with postoperative gastroparesis syndrome who met the inclusion criteria were randomly divided into two groups. The control group was treated with metoclopramide. The experimental group was treated with acupuncture. Before and after treatment, the time of gastrointestinal motility recovery, the mean total score of main symptom index of gastroparesis and the change of gastrointestinal drainage flow were observed before and after treatment. The changes of serum motilin levels were detected by double antibody sandwich enzyme-linked immunosorbent assay (Elisa). All the data of statistical analysis were analyzed by SPSS 20.0 software: age. The recovery time of gastrointestinal motility, the mean gastrointestinal drainage volume and the grade of gastroparesis were examined by two independent samples t-test or rank sum test. Sex, the primary type of disease was tested by four-cell table chi-square test or RXC column Chi-square test. The mean total score of the main symptom index and serum motilin level in the two groups were compared by two independent samples t test or rank sum test, and the matched sample t test or rank sum test were used in the intragroup comparison. Results 1. General data analysis: before treatment, the age, sex, primary disease type and grade of gastroparesis were compared between the two groups. There was no significant difference between the two groups (P 0.05). The recovery time of gastrointestinal motility: the difference between the two groups was statistically significant (P 0.05). Mean total score of main symptom index of gastroparesis: the total score of mean index of main symptoms of gastroparesis before and after treatment was significantly different between the two groups (P 0.05). After treatment, the total scores of the main symptoms of gastroparesis in the two groups were compared, the difference was statistically significant (P 0.05), and the mean gastrointestinal drainage volume: the mean gastrointestinal drainage volume was compared between the two groups. The difference was statistically significant (P 0.05). 5, serum motilin level: the difference of serum motilin level between the two groups before and after treatment was statistically significant (P 0.05). After treatment, the serum motilin levels in the two groups were significantly different (P 0.05). Conclusion 1. Both acupuncture and metoclopramide can improve the clinical symptoms of patients with gastroparesis syndrome after abdominal surgery, reduce gastrointestinal drainage and shorten the treatment days. Both acupuncture and metoclopramide can increase the level of serum motilin. The effect of acupuncture was better than that of metoclopramide. Acupuncture of "Tongfu removing Man method" had more advantages in the treatment of postoperative gastroparesis syndrome, and its mechanism might be related to promoting the secretion of serum motilin.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.2

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