中医药治疗上消化道出血控制后患者继发胃肠功能障碍的临床效果
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摘要
目的探讨中医药治疗上消化道出血控制后患者继发胃肠功能障碍的临床效果。方法选取2016年3月～2017年2月我院收治的100例上消化道出血控制后继发胃肠功能障碍患者作为研究对象,根据治疗方式分为对照组和研究组,每组各50例。对照组采取常规的西医药物治疗,研究组在对照组的基础上行中医药治疗,比较两组患者治疗前后的排便次数、肠道哮鸣音、腹内压力、胃肠功能评分及多器官功能障碍综合征(MODS)发生率。结果两组患者治疗前的排便次数、肠鸣音次数、腹内压、胃肠道功能评分比较,差异无统计学意义(P>0.05);研究组治疗3、7 d后的排便次数、肠鸣音次数均多于对照组,差异有统计学意义(P<0.05);研究组治疗7 d后的腹内压、胃肠道功能评分均高于对照组,差异有统计学意义(P<0.05);研究组的MODS发生率低于对照组,差异有统计学意义(P<0.05)。结论对于上消化道出血控制后患者继发胃肠功能障碍采取中医药治疗的临床效果显著,可恢复胃肠道功能,降低并发症发生率,值得在临床中推广实施。
Objective To study and determine the clinical effects of traditional Chinese medicine for patients with secondary gastrointestinal dysfunction after control of upper gastrointestinal bleeding. Methods One hundred cases of patients with secondary gastrointestinal dysfunction after control of upper gastrointestinal bleeding treated in our hospital from March 2016 to February 2017 were selected as the subjects, and divided into control group and study group, with50 cases in each group. The control group was given conventional western medicine treatment, and the study group was given traditional Chinese medicine treatment on the basis of control group. The frequency of defecation, number of bowel wheezing, intra-abdominal pressure, gastrointestinal function score and incidence of multiple organ dysfunction syndrome(MODS) were compared between the two groups before and after treatment. Results There were no significant differences in the frequency of defecation, number of bowel wheezing, intra-abdominal pressure and gastrointestinal function scores between the two groups before treatment(P>0.05). The frequency of defecation and number of bowel wheezing in the study group were more than those in the control group afte 3 and 7 days treatment, and the differences were statistically significant(P<0.05). The intra-abdominal pressure and gastrointestinal function scores in the study group were higher than those in the control group afte 7 days treatment, and the differences were statistically significant(P<0.05). The incidence of MODS in the study group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusion The clinical effect of traditional Chinese medicine for patients with secondary gastrointestinal dysfunction after control of upper gastrointestinal bleeding is significant. It can restore gastrointestinal function and reduce the incidence of complications. It is worthy of promotion in clinical practice.
Objective To study and determine the clinical effects of traditional Chinese medicine for patients with secondary gastrointestinal dysfunction after control of upper gastrointestinal bleeding. Methods One hundred cases of patients with secondary gastrointestinal dysfunction after control of upper gastrointestinal bleeding treated in our hospital from March 2016 to February 2017 were selected as the subjects, and divided into control group and study group, with50 cases in each group. The control group was given conventional western medicine treatment, and the study group was given traditional Chinese medicine treatment on the basis of control group. The frequency of defecation, number of bowel wheezing, intra-abdominal pressure, gastrointestinal function score and incidence of multiple organ dysfunction syndrome(MODS) were compared between the two groups before and after treatment. Results There were no significant differences in the frequency of defecation, number of bowel wheezing, intra-abdominal pressure and gastrointestinal function scores between the two groups before treatment(P>0.05). The frequency of defecation and number of bowel wheezing in the study group were more than those in the control group afte 3 and 7 days treatment, and the differences were statistically significant(P<0.05). The intra-abdominal pressure and gastrointestinal function scores in the study group were higher than those in the control group afte 7 days treatment, and the differences were statistically significant(P<0.05). The incidence of MODS in the study group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusion The clinical effect of traditional Chinese medicine for patients with secondary gastrointestinal dysfunction after control of upper gastrointestinal bleeding is significant. It can restore gastrointestinal function and reduce the incidence of complications. It is worthy of promotion in clinical practice.
引文
[1]赖伟兰,蔡海荣,郭永宁.中医集束化护理在重症胰腺炎胃肠功能障碍患者中的应用[J].中国中医急症,2017,26(7):1315-1316.
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[11]李剑琴,胡智伟,薛志涛,等.中西医结合治疗重症病人上消化道出血临床疗效观察[J].世界中西医结合杂志,2016,11(6):848-850.
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[13]汤小芳.中药健脾止血汤加减治疗消化性溃疡合并上消化道出血41例临床研究[J].陕西中医药大学学报,2016,(5):56-58.
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[15]程胜平,周世龙,陆维宏.内镜直视下应用中药复方石榴皮五倍子诃子液对上消化道出血的疗效观察[J].中华中医药学刊,2014,32(2):432-434.
[2]殷丽梅.中医护理技术应用对脓毒症患者胃肠功能障碍的影响及护理体会[J].中医药临床杂志,2014,12(12):1306-1307.
[3]冯泽会,朱委.中医综合干预对术后胃肠功能障碍患者预后与炎症因子的影响[J].河南中医,2016,36(3):501-503.
[4]付跃峰,刘清泉,蔡阳平.AECOPD呼吸衰竭中医证素、证候的分布及与胃肠功能障碍相关研究[J].世界中医药,2014,9(3):265-269.
[5]王筠,张宏,侯维维.中医药治疗上消化道出血控制后患者继发胃肠功能障碍的临床观察[J].中国中医急症,2014,23(5):973-975.
[6]陈家林.探讨消化内科上消化道出血患者的临床诊断和治疗体会[J].东方食疗与保健,2016,15(6):18.
[7]许敏怡,熊秀萍,沈瑜倩.危重症患者胃肠功能障碍的中医证候学研究[J].中国中医急症,2015,24(1):69-71.
[8]黄国华.中药泻心汤联合奥美拉唑治疗上消化道出血24例[J].中国药业,2013,22(6):119.
[9]马超,孔德润.中药止血汤联合内镜下组织胶注射治疗肝硬化并发胃底静脉出血28例临床分析[J].安徽医药,2016,20(10):1953-1956.
[10]周有智.止血散联合凝血酶及奥美拉唑治疗急性上消化道出血的效果研究[J].中国当代医药,2017,24(27):67-69.
[11]李剑琴,胡智伟,薛志涛,等.中西医结合治疗重症病人上消化道出血临床疗效观察[J].世界中西医结合杂志,2016,11(6):848-850.
[12]徐玲.中药泻心汤联合奥美拉唑治疗上消化道出血的临床效果分析[J].当代医学,2018,24(2):110-111.
[13]汤小芳.中药健脾止血汤加减治疗消化性溃疡合并上消化道出血41例临床研究[J].陕西中医药大学学报,2016,(5):56-58.
[14]杨梦.中医中药治疗非静脉曲张性上消化道出血的临床分析[J].医药,2015,12(6):214..
[15]程胜平,周世龙,陆维宏.内镜直视下应用中药复方石榴皮五倍子诃子液对上消化道出血的疗效观察[J].中华中医药学刊,2014,32(2):432-434.