香槟方对腰椎融合术后胃肠功能影响的临床研究

发布时间：2018-12-16 21:47

【摘要】：目的：在香槟方动物实验的基础上,研究临床腰椎术后患者内服香槟方后腹胀痛、肠鸣音、肛门排气排便以及恶心呕吐的变化情况,阐明香槟方对腰椎术后胃肠功能恢复的影响,为发挥中药在腰椎围手术期的特色与优势,为脊柱术后患者快速康复研究奠定基础。方法：收集广东省中医院住院部单、双节段腰椎融合术患者60例,按随机数字表,随机分为两组,分别为实验组、对照组,每组各30例,术前1天记录所有患者腹痛腹胀、排气排便及肠鸣音等情况,术后第1天两组开始给药,在术后常规治疗基础上,实验组服用中药香槟方(槟榔10g、人参9g、乌药10g、砂仁6g、桃仁l0g)治疗；对照组服用安慰剂,直至术后第7天。每日1剂,分别在早上9：00、下午16：00服用。分别在术后6h(17：00-1：00)、术后第1天(1：00-9：00)、术后第1天(9：00-17：00)、术后第1天(17：00-1：00)、术后第2天(1：00-9：00)、术后第2天(9：00-17：00)、术后第2天(17：00-1：00)、术后第3天、术后第4天、术后第5天、术后第6天、术后第7天记录肠鸣音活动情况,记录术后肛门首次排气及术后首次排便时间；记录术后腹胀、恶心呕吐等胃肠道变化情况,并通过围手术期术后胃肠功能评价标准量表评价,建立数据,用统计SPSS13.0数据软件对数据进行处理。结果：1.术后肠鸣音恢复时间两组平均值分别为17.99h和25.12h,差异具有统计学意义。(p=0.000,p0.01)；2.术后首次排气时间两组平均值分别为16.87h和20.42h,差异具有统计学意义。(p=0.049,p0.05)；3.术后首次排便时间两组平均值分别为60.26h和75.7h,差异具有统计学意义。(p=0.002,p0.01)；4.根据围手术期术后胃肠功能评价标准量表,实验组在术后第一天(9：00～17：00)至术后第7天在各个时间段的平均得分均高于对照组,两者差异具有统计学意义,即p0.01,其中实验组在术后第1天(9：00～17：00)、(17：00～1：00)以及术后第2天(1：00-9：00)三个时间段里,实验组平均得分都介于60～79分之间,对照组平均得分都低于60分,实验组平均得分比对照组高,且两组差异有统计学意义(P0.01)；在术后第2天(9：00～17：00),实验组平均得分高于80分,对照组平均得分仍低于60分,两组有明显差异,具有统计学意义(P0.01)；在术后第2天(17：00～1：00)到术后第4天,实验组平均得分高于对照组,对照组仍低于60分,两组差异明显且有统计学意义(P0.01)；在术后第5天,实验组平均得分高于对照组,实验组平均得分高于90分,对照组平均得分介于60～79之间,两组有差异且有统计学意义(P0.01)；在术后第6、7天,实验组平均得分高于对照组,实验组平均得分高于90分,对照组平均得分高于80分,两者有差异且有统计学意义(P0.01)。5.所有患者经全程治疗后,均未出现头痛、头晕、皮疹等不良事件。结论：香槟方能促使腰椎融合术患者术后肠鸣音恢复、提早肛门排气及排便时间,总体临床疗效良好,值得推广。
[Abstract]:Objective: to study the changes of abdominal distension pain, bowel sound, anal exhaust and defecation, nausea and vomiting in patients after lumbar vertebrae operation on the basis of animal experiment of Champagne Fang. To clarify the effect of Champagne recipe on the recovery of gastrointestinal function after lumbar vertebra operation, to give full play to the characteristics and advantages of traditional Chinese medicine in the perioperative period of lumbar vertebrae, and to lay a foundation for the study of rapid rehabilitation of patients after spinal surgery. Methods: sixty patients with single and double segmental lumbar fusion in Guangdong traditional Chinese Medicine Hospital were randomly divided into two groups: experimental group (n = 30) and control group (n = 30). Abdominal pain and abdominal distension were recorded one day before operation. On the first day after operation, the two groups were given drugs. On the basis of routine treatment, the experimental group was treated with Champagne prescription (areca nut 10g, ginseng 9g, black medicine 10g, Amomum villosum 6g, peach kernel 10g). The control group was given placebo until 7 days after operation. Take one dose a day at 9: 00 in the morning and 16:00 in the afternoon. At 6 hours (17: 00-1: 00), on the first day (1: 00-9: 00), on the first day (9: 00-17: 00), on the first day (17: 00-1: 00), on the second day (1: 00-9: 00), The second day (9: 00-17: 00), the second day (17: 00-1: 00), the third day, the fourth day, the fifth day, the sixth day and the seventh day after the operation were recorded. The first exsufflation of anus and the time of first defecation after operation were recorded. The changes of gastrointestinal tract such as abdominal distension, nausea and vomiting were recorded, and the data were established by using the perioperative gastrointestinal function evaluation scale. The data were processed by statistical SPSS13.0 data software. Results: 1. The average recovery time of postoperative bowel sounds was 17.99 h and 25.12 h, respectively, the difference was statistically significant (p0. 000 / p0.01); 2. The mean of the first time after operation was 16.87 h and 20.42 h, respectively. The difference was statistically significant (p0.049, p0.05). The mean of the first defecation time was 60.26 h and 75.7 h, respectively, the difference was statistically significant (p0. 002 / p0.01); 4. According to the evaluation scale of postoperative gastrointestinal function in perioperative period, the average scores of the experimental group were higher than those of the control group from the first day (9: 00: 17: 00) to the 7th day after operation, and the difference was statistically significant. That is, p0.01. In the experimental group, the average score of the experimental group in the first day (9: 00: 00), (17: 00 1: 00) and the second day after operation (1: 00-9: 00) was between 6079 and 6079. The average score of the control group was lower than that of the control group, and the average score of the experimental group was higher than that of the control group, and the difference between the two groups was statistically significant (P0.01). On the second day after operation (9: 00 17: 00), the average score of the experimental group was higher than 80 points, while the average score of the control group was still lower than 60 points. There was a significant difference between the two groups (P0.01). From the second day after operation (17: 00 1: 00) to the fourth day after operation, the average score of the experimental group was higher than that of the control group, and the control group was still lower than 60 points. The difference between the two groups was significant (P0.01). On the 5th day after operation, the average score of the experimental group was higher than that of the control group, the average score of the experimental group was more than 90 points, and the average score of the control group was between 600.79. The difference between the two groups was statistically significant (P0.01). On the 6th day after operation, the average score of the experimental group was higher than that of the control group, the average score of the experimental group was more than 90 points, and the average score of the control group was higher than 80 points, the difference was statistically significant (P0.01). There were no adverse events such as headache, dizziness, rash and so on. Conclusion: Champagne prescription can promote the recovery of bowel sound and the time of anal exhaust and defecation in patients with lumbar fusion. The overall clinical effect is good and worth popularizing.
【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】：R274.9

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