胆囊结石的中医体质与腹腔镜术后胃肠功能恢复的相关性

发布时间：2018-01-21 17:33

本文关键词： 腹腔镜胆囊切除术中医体质胃肠道功能恢复　出处：《安徽中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的探讨胆囊结石患者中医体质与其腹腔镜术后胃肠功能恢复的相关性,找出影响术后胃肠功能恢复的体质类型。方法选择武警安徽总队医院2015年1月至2015年12月收治的480例胆囊结石伴急性胆囊炎患者作为研究对象。中医体质的分类方法采用2009年国家制定的《中医体质分类与判定》标准进行分类,中医体质辨识方法采用王琦教授团队研发的体质量表进行问卷调查。由患者独立填写问卷表,填完后当场收回。对填写有障碍者则由调查员协助填写。收集中医体质类型资料和不同体质患者手术时间、术后腹胀时间、肠鸣音恢复时间、肛门排气、排便时间变化资料,以及手术前后胃肠激素水平变化资料。建立数据库,采用SPSS16.0统计分析软件进行数据统计和计算。观察480例胆囊结石患者中医体质分布情况,比较不同体质患者手术时间、术后腹胀时间、肠鸣音恢复时间、肛门排气、排便时间差异,比较不同体质患者手术前后血清胃肠激素水平变化差异。P0.05为显著性差异。找出影响腹腔镜胆囊切除术后胃肠功能恢复的中医体质类型。结果本次参与调查的480例胆囊结石患者九种中医体质类型由多到少的分布顺序为:湿热质、痰湿质、气虚质、平和质、气郁质、血瘀质、阴虚质、阳虚质、特禀质。不同体质患者手术时间虽然不同,但无统计学意义,而术后腹胀时间、肠鸣音恢复时间、肛门排气、排便时间存在差异性,以气虚质、湿热质患者术后腹胀时间、肠鸣音恢复时间、肛门排气、排便时间与其他体质显著不同(P0.05)。不同体质患者术后血清胃动素(MTL)、胃泌素(GAS)水平较术前下降(P0.05),血管活性肠肽(VIP)水平较术前升高(P0.05),生长抑素(SS)水平较术前下降(P0.05)。以气虚质和湿热质患者MTL、GAS水平显著低于其他体质(P0.05),VIP水平显著高于其他体质(P0.05),但两者SS水平与其他体质相比无显著差异(P0.05)。结论不同中医体质的胆囊结石患者行腹腔镜手术后胃肠功能恢复不同。相比其他中医体质类型,气虚质和湿热质患者术后胃肠功能恢复较慢。
[Abstract]:Objective to investigate the relationship between the physique of traditional Chinese medicine (TCM) and the recovery of gastrointestinal function after laparoscopic surgery in patients with cholecystolithiasis. Methods 480 patients with cholecystolithiasis associated with acute cholecystitis were selected from January 2015 to December 2015 in Anhui General Hospital of Armed Police. For example, the classification method of TCM constitution is classified according to the Standard of Classification and judgment of TCM Constitution established by the State in 2009. The physique identification method of TCM was based on the physique scale developed by Professor Wang Qi. The patients filled out the questionnaire independently. On the spot after filling out. For those with disabilities, the investigators help fill in. Collect the information of TCM physique type and different physique patient operation time, postoperative abdominal distension time, bowel sound recovery time, anal exhaust. Data of defecation time change and gastrointestinal hormone level before and after operation. The distribution of TCM constitution in 480 patients with cholecystolithiasis was observed and the time of operation and postoperative abdominal distension were compared by using SPSS16.0 software. The recovery time of bowel sounds, anal exhaust, defecation time difference. To compare the changes of serum gastrointestinal hormone levels before and after operation in patients with different physiques. P05 was a significant difference. To find out the influence of laparoscopic cholecystectomy on the recovery of gastrointestinal function of traditional Chinese medicine physique type. The distribution order of nine types of TCM constitution in 480 patients with cholecystolithiasis was as follows:. Wet and hot. Phlegm dampness, qi deficiency, calmness, qi stagnation, blood stasis, yin deficiency, yang deficiency, intrinsic quality. Different physique patients have different operation time, but no statistical significance, and postoperative abdominal distension time. The recovery time of bowel sound, anal exhaust and defecation time were different. The time of abdominal distension, the recovery time of bowel sound and anal exhaust existed in patients with deficiency of qi and damp and heat. The time of defecation was significantly different from that of other physiques (P 0.05). The serum levels of motilin and gastrin in patients with different physiques after operation were significantly lower than those before operation (P 0.05). The level of vasoactive intestinal peptide (VIP) was higher than that before operation (P 0.05), and the level of somatostatin (SS) was lower than that before operation (P 0.05). MTL was found in patients with deficiency of qi and dampness and heat. The level of GAS was significantly lower than that of other constitution (P0.05). However, there was no significant difference in SS level between the two groups compared with other physique. Conclusion the gastrointestinal function of cholecystolithiasis patients with different constitution of traditional Chinese medicine is different after laparoscopic operation. The recovery of gastrointestinal function was slower in patients with qi deficiency and damp heat after operation.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R269

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