电针足三里对外科腹部术后胃肠动力恢复影响的临床研究

发布时间：2018-01-10 18:05

本文关键词：电针足三里对外科腹部术后胃肠动力恢复影响的临床研究　出处：《广州中医药大学》2013年硕士论文　论文类型：学位论文

【摘要】：研究目的本研究应用流行病学方法,以随机对照为原则进行前瞻性研究,探讨并科学系统地评价电针足三里促进术后胃肠动力恢复的影响及安全性,并形成技术操作规范,便于临床推广。研究方法选取广东省中医院外五科住院行中等腹部手术治疗患者96例,遵循随机对照的科研设计分为对照组(常规治疗组)48例及试验组(电针足三里组)48例,术后分别给予基础治疗及基础治疗加电针双侧足三里,观察两组病例术后胃肠动力恢复的情况。研究结果 1、电针足三里对术后胃肠动力恢复具有一定的疗效,在肠鸣音恢复、排气、排便时间、术后—出院时间上均短于空白对照组,但未显示统计学意义。 2、分层结果显示：1)在非单纯阑尾及胆囊手术组、胃肠道手术组、开放手术组中,两组间在术后首次排气时间和肠鸣音正常时间的情况比较上,具有统计学意义(PO.05)。在首次排便、饮食时间比较上,无统计学意义(P0.05)；2)而在非胃肠道手术组、腹腔镜手术组两组对比上,肠鸣音恢复,排气,排便,饮食时间上差异无统计学意义。 3、两组术后第一天VIP水平均较术前显著升高,与空白组相比,电针足三里组术后第三天VIP水平显著低于空白对照组,具有显著统计学意义(P0.05)。两组术后第一天MLT水平较术前显著降低,电针足三里组术后第三天胃动素水平显著低于空白对照组,具有显著统计学意义(P0.05)。 4、不同观察时点胃肠功能恢复情况分析显示：1)腹胀情况：在观察时点2、4上具有统计学差异(P0.05)；其余时点比较差异无统计学意义；2)腹痛情况：在观察时点2、3上具有统计学意义(P0.05)；其余时点比较差异无统计学意义；3)恶心呕吐情况：各时点比较差异无统计学意义；4)饥饿感情况：时点比较差异无统计学意义。 5、安全性情况分析显示：两组间在不良事件发生,退出情况,合并用药上比较均差异无统计学意义。结论电针足三里对外科腹部术后胃肠动力恢复优于常规治疗,同时改善腹部术后临床症状,特别是对于传统,开放,胃肠道手术更具疗效,缩短住院时间,患者无不良反应,安全性高,可在临床广泛推广。
[Abstract]:research objective
In this study, we applied epidemiological method and randomized controlled trial to conduct a prospective study. We explored and systematically evaluated the effect and safety of electroacupuncture at Zusanli on postoperative gastrointestinal motility recovery, and formed technical operation rules to facilitate clinical promotion.
research method
Guangdong Province Traditional Chinese Medical Hospital hospital for five selected secondary abdominal surgery in patients with 96 cases, follow the scientific research design randomized divided into control group (conventional treatment group) 48 cases and the experimental group (electroacupuncture group) 48 cases, after operation were given basic treatment and basic treatment plus Electroacupuncture bilateral Zusanli, recovery of gastrointestinal motility was observed in the two groups cases after the operation.
Research results
1, electroacupuncture has a certain effect on the recovery of gastrointestinal motility after operation, bowel sound recovery, exhaust, defecation time, postoperative discharge time and were shorter than control group, but showed no statistical significance.
2, the results showed that: 1) in stratified non simple appendectomy and cholecystectomy group, gastrointestinal surgery group and open surgery group, the comparison between the two groups in the time of flatus and bowel sounds of normal time, with statistical significance (PO.05). In the first defecation, diet time, no significant the significance (P0.05); 2) in the non gastrointestinal surgery, laparoscopic surgery group, two group comparison, borborygmus, exhaust, defecation, diet had no significant differences on time.
3, the two groups after the first day of VIP were significantly higher than those before the operation, compared with the control group, third days VIP electroacupuncture group after operation was significantly lower than the control group, there was a statistically significant (P0.05). The first day the level of MLT was significantly lower than preoperative in two group after third days, the levels of motilin in electroacupuncture Zusanli group after operation was significantly lower than the control group, there was a statistically significant (P0.05).
4 different observation point, the recovery of gastrointestinal function analysis showed: 1) abdominal distension: in the observation point 2,4 has statistically significant difference (P0.05); the other time points had no significant difference; 2) abdominal pain in the observation point has statistical significance on 2,3 (P0.05); the other time points had no significant difference; 3) nausea and vomiting: at each time point had no significant difference; 4) hunger: the time difference was not statistically significant.
5, the analysis of the safety situation showed that there was no statistical difference between the two groups in the occurrence of adverse events, the withdrawal of the situation, and the combination of the drugs.
conclusion
Electroacupuncture at Zusanli is better than conventional treatment in the recovery of gastrointestinal motility after surgical abdominal operation, and at the same time, it improves the clinical symptoms after abdominal operation. Especially for traditional open surgery, gastrointestinal surgery is more effective, shorter hospitalization time, no adverse reactions and high safety, and it can be widely promoted in clinical practice.

【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】：2013
【分类号】：R246

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