电针单穴与多穴位对腹腔镜术后胃肠功能恢复的差异观察

发布时间：2018-01-31 18:41

本文关键词： 电针足三里上巨虚下巨虚腹腔镜术后胃肠动力　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：本课题是通过观察腹部腹腔镜术后首次排气、排便、肠鸣音恢复的时间及腹胀、腹痛、恶心呕吐等反应胃肠功能恢复的指标,探讨电针足三里与电针足三里加上、下巨虚对腹腔镜下腹部术后胃肠功能恢复的有效性及差异性,为优化电针选穴提供依据。方法：从广东省中医院珠海医院外科病房选取80例腹部术后(腹腔镜术后)患者,采取随机对照试验的方法,将患者分为治疗组：电针足三里、上巨虚、下巨虚组和对照组：电针足三里组各40例。两组病人术后常规给予禁食、心电监护、低流量给氧、常规外科护理、术口TDP灯术照灯治疗、抗感染、补液等治疗措施,如病情严重及较大胃肠手术病人需长期禁食,则给予肠外营养支持等治疗方法。两组病人均加用电针治疗,对照组加用电针双侧足三里,治疗组加用电针双侧足三里、上巨虚、下巨虚,每日电针2次,术后6小时开始电针治疗,并监测患者电针前后肠鸣音、恶心呕吐、腹胀、腹痛等情况；同时对病人的第一次排气、第一次排便、肠鸣音恢复时间的时间进行记录。创建数据库,并且运用SPSS19.0进行统计学分析。成果：电针足三里、上巨虚、下巨虚组对术后病人的胃肠动力障碍的治疗效果较电针足三里组更为有效,电针足三里、上巨虚、下巨虚组较电针足三里组的肠鸣音恢复时间、首次排气时间、首次排便时间均缩短。电针足三里组肠鸣音恢复时间平均为14.53±2.43h,电针足三里、上巨虚、下巨虚组首次排气时间平均为12.75±2.18h,两组之间肠鸣音恢复时间的差别具有统计学意义,p＜0.05；电针足三里组首次排气时间平均为21.53±4.74h,电针足三里、上巨虚、下巨虚组首次排气时间平均为19.28±4.34h,两组之间首次排气时间的差别具有统计学意义,p＜0.05；电针足三里组首次排便时间平均为27.88+4.69h,电针足三里、上巨虚、下巨虚组首次排便时间平均为24.68±4.00h,两组之间首次排便时间的差别具有统计学意义,p＜0.05。两组之间在性别、年龄、身高、体重等方面经T检验,均无统计学意义。两组之间治疗前症状评分经统计学分析,p＞0.05,两组之间的差别无统计学意义。两组之间治疗后的症状评分情况,治疗组较对照组的疗效更为显著,两组之间的差别具有统计学意义,p＜0.05。结论：电针足三里联合上巨虚、下巨虚对腹部腹腔镜术后患者胃肠动力恢复较单纯电针足三里有更加明显的促进作用,肠鸣音恢复时间及第一次排气、排便出现时间提前,术后症状改善更加明显。
[Abstract]:Objective: to observe the time of recovery of ventral distension, abdominal pain, nausea and vomiting, and to observe the recovery time of ventriculus, defecation, bowel sound and abdominal distension, abdominal pain, nausea and vomiting after abdominal laparoscopy. To explore the effectiveness and difference between electroacupuncture Zusanli and electroacupuncture Zusanli plus Xiabu deficiency in the recovery of gastrointestinal function after laparoscopic abdominal surgery. Methods: 80 patients after abdominal surgery (laparoscopic operation) were selected from the surgical ward of Zhuhai Hospital of traditional Chinese Medicine of Guangdong Province. The patients were divided into treatment group: electroacupuncture Zusanli group, upper Juxu group, lower Juxu group and control group: electroacupuncture Zusanli group (40 cases each). The patients in both groups were given fasting, ECG monitoring, low flow oxygen supply, routine surgical nursing after operation. Surgical mouth TDP lamp light therapy, anti-infection, fluid rehydration and other treatment measures, such as serious illness and large gastrointestinal surgery patients need long-term fasting. Two groups of patients were treated with electroacupuncture, the control group with electroacupuncture bilateral Zusanli, the treatment group with electric acupuncture bilateral Zusanli, the treatment group with bilateral Zusanli, the upper giant asthenia, the lower giant asthenia, 2 times daily electroacupuncture. The patients were treated with electroacupuncture at 6 hours after operation. The patients were monitored for bowel sounds, nausea and vomiting, abdominal distension and abdominal pain before and after electroacupuncture. At the same time, the patient's first exhaust, the first defecation, bowel sound recovery time to record. Create a database, and use SPSS19.0 for statistical analysis. Results: electroacupuncture Zusanli. The treatment of gastrointestinal motility disorder was more effective in the upper and lower giant asthenia group than in the electroacupuncture Zusanli group. The recovery time of the bowel sounds in the electroacupuncture Zusanli group, the upper giant asthenia group and the lower giant asthenia group was longer than that in the electroacupuncture Zusanli group. The time of first venting and the time of first defecation were all shortened. The recovery time of bowel sound in electroacupuncture Zusanli group was 14.53 卤2.43 h, and electroacupuncture in Zusanli, Shangjuxu. The average initial exhaust time of Xiazhuxu group was 12.75 卤2.18 h, and the difference between the two groups was statistically significant (P < 0.05). The mean initial exhaust time of electroacupuncture Zusanli group was 21.53 卤4.74 h, that of electroacupuncture Zusanli group was 19.28 卤4.34 h. The difference of the first exhaust time between the two groups was statistically significant (p < 0.05). The mean first defecation time of electroacupuncture Zusanli group was 27.88 4.69 h, that of electroacupuncture Zusanli group was 24.68 卤4.00 h, that of Zusanli group was 24.68 卤4.00 h. The difference of the first defecation time between the two groups was statistically significant (P < 0.05). The sex, age, height and weight of the two groups were tested by T test. There was no statistical significance between the two groups. The scores of symptoms before treatment between the two groups were statistically analyzed (p > 0.05), and the difference between the two groups was not statistically significant, and the scores of symptoms after treatment between the two groups were not statistically significant. The curative effect of the treatment group was more significant than that of the control group, the difference between the two groups was statistically significant (p < 0.05). Conclusion: electroacupuncture Zusanli combined with Shangjuxu. The recovery of gastrointestinal motility after abdominal laparoscopy was more obvious than that of electroacupuncture in Zusanli patients. The recovery time of bowel sound and the first time of exhaust and defecation appeared earlier. The improvement of postoperative symptoms was more obvious.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R656

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