行气活血汤对腹腔镜胆囊切除术后血清炎症因子、胃肠功能及并发症影响
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摘要
目的:探讨行气活血汤对腹腔镜胆囊切除术(LC)术后患者血清炎症因子、肠胃功能及并发症的影响。方法:选取2017年5月—2018年7月于我院择期行LC治疗的112例患者,利用随机数字表法将这112例患者随机分成观察组(n=56)与对照组(n=56)。两组术后均常规给予相同的补液及抗感染等支持治疗,观察组在此基础上联合行气活血汤内服。比较两组术后胃肠功能恢复情况,手术前后检测两组炎症因子[白介素(IL-6)、肿瘤坏死因子(TNF-α)、C反应蛋白(CRP)]及胃肠激素[胃泌素(GAS)、胃动素(MTL)、血管活性肠肽(VIP)]血清水平,并统计两组术后并发症发生情况。结果:观察组术后进食、肠鸣音恢复、肛门排气及排便时间均明显短于对照组(P<0.05)。观察组术后1、3 d时血清GAS、MTL浓度较对照组同期均显著更高(P<0.05),而VIP水平则均显著更低(P<0.05);且观察组术后1、3 d时各项炎性因子(IL-6、TNF-α、CRP)血清含量均显著低于对照组同期(P<0.05)。观察组无恶心腹胀发生,其恶心腹胀发生率显著低于对照组(7.14%,P<0.05)。结论:LC术后应用行气活血汤辅助治疗能有效缓解患者机体炎症反应,促进胃肠功能的恢复,且尚可减少并发症发生。
Objective:To explore effect of Xingqi Huoxue Decoction on serum inflammatory factors,gastrointestinal function and complications after laparoscopic cholecystectomy(LC). Methods:Selected112 cases who underwent elective LC treatment in our hospital from May 2017 to July 2018,and divided them into observation group(n=56)and control group(n=56)randomly. Provided same rehydration and anti-infective supportive treatment to both group routinely,provided oral Xingqi Huoxue Decoction to observation group additionally. Compared two groups' postoperative gastrointestinal function recovery,inflammatory factors [interleukin(IL-6),tumor necrosis factor(TNF-α),C-reactive protein(CRP)],gastrointestinal hormones [gastrin(GAS),motilin(MTL),vasoactive intestinal peptide(VIP)] levels in serum before and after operation,as well as statistics of postoperative complications in both groups.Results:Observation group's postoperative feeding,bowel sound recovery,anal exhaust and defecation time were significant shorter than those in control group(P<0.05). Observation group's serum GAS,MTL concentration at postoperative 1,3 d were significant higher than those in control group(P<0.05),and VIP level was significant lower(P<0.05),and observation group's serum levels of inflammatory factors(IL-6,TNF-α,CRP)at 1,3 d were significant lower than those in control group at same time(P<0.05). There was no nausea and abdominal distension in observation group,and the incidence of nausea and abdominal distension was significant lower than that in control group(7.14%,P<0.05). Conclusion:The application of Xingqi Huoxue Decoction helps patients after LC operation to alleviate the inflammatory response and promote the recovery of gastrointestinal function effectively,as well as reduce complications.
Objective:To explore effect of Xingqi Huoxue Decoction on serum inflammatory factors,gastrointestinal function and complications after laparoscopic cholecystectomy(LC). Methods:Selected112 cases who underwent elective LC treatment in our hospital from May 2017 to July 2018,and divided them into observation group(n=56)and control group(n=56)randomly. Provided same rehydration and anti-infective supportive treatment to both group routinely,provided oral Xingqi Huoxue Decoction to observation group additionally. Compared two groups' postoperative gastrointestinal function recovery,inflammatory factors [interleukin(IL-6),tumor necrosis factor(TNF-α),C-reactive protein(CRP)],gastrointestinal hormones [gastrin(GAS),motilin(MTL),vasoactive intestinal peptide(VIP)] levels in serum before and after operation,as well as statistics of postoperative complications in both groups.Results:Observation group's postoperative feeding,bowel sound recovery,anal exhaust and defecation time were significant shorter than those in control group(P<0.05). Observation group's serum GAS,MTL concentration at postoperative 1,3 d were significant higher than those in control group(P<0.05),and VIP level was significant lower(P<0.05),and observation group's serum levels of inflammatory factors(IL-6,TNF-α,CRP)at 1,3 d were significant lower than those in control group at same time(P<0.05). There was no nausea and abdominal distension in observation group,and the incidence of nausea and abdominal distension was significant lower than that in control group(7.14%,P<0.05). Conclusion:The application of Xingqi Huoxue Decoction helps patients after LC operation to alleviate the inflammatory response and promote the recovery of gastrointestinal function effectively,as well as reduce complications.
引文
[1]Evers L,Bouvy N,Branje D,et al. Single-incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy a systematic review and meta-analysis[J].Surgical Endoscopy,2017,31(9):3437-3448.
[2]贾利猛,杜剑,欧云崧.腹腔镜胆囊切除术对老年胃肠功能恢复及并发症的影响[J].中国现代普通外科进展,2017,20(6):465-467.
[3]Aspinen S,Kinnunen M,Harju J,et al. Inflammatory response to surgical trauma in patients with minilaparotomy cholecystectomy versus laparoscopic cholecystectomy a randomised multicentre study[J]. Scandinavian journal of gastroenterology,2016,51(6):739-744.
[4]初阳.活血行气中药联合镇痛药治疗膝骨关节炎关节镜术后疼痛及对炎性因子影响[J].辽宁中医药大学学报,2017,19(6):207-209.
[5]崔贺华,刘云贺,何笑雨.二氧化碳气腹压对行腹腔镜胆囊切除术患者血流动力学及胃肠功能影响[J].新乡医学院学报,2016,33(4):321-324.
[6]Kim GH,Lee HD,Min K,et al. Fate of Dyspeptic or Colonic Symptoms After Laparoscopic Cholecystectomy[J]. Journal of Neurogastroenterology&Motility,2014,20(2):253-260.
[7]张洵,温达,王伟.单切口腹腔镜胆囊切除术对患者胃肠功能及血清IMA、APN及GAS的影响[J].中国临床研究,2018,31(5):648-652.
[8]董璐.针灸联合运脾饮治疗腹部外科全麻非胃肠术后胃肠功能紊乱疗效观察[J].现代中西医结合杂志,2017,26(28):3126-3128.
[9]王林月,吴伟梁,张立清.柴胡疏肝散合平胃散对腹腔镜胆囊切除术后胃肠功能的影响[J].中国中西医结合外科杂志,2017,23(1):69-71.
[10]葛正息,王晓斌,秦颖.加味大承气汤对高龄结石性胆囊炎患者腹腔镜胆囊切除术后胃肠功能恢复的影响[J].现代中西医结合杂志,2018,27(7):772-775.
[11] Aspinen S,Kinnunen M,Harju J,et al. Inflammatory response to surgical trauma in patients with minilaparotomy cholecystectomy versus laparoscopic cholecystectomy a randomised multicentre study[J]. Scandinavian Journal of Gastroenterology,2016,51(6):1.
[12] Agarwal BB,Nanavati JD,Agarwal N,et al. Biomolecular inflammatory response to surgical energy usage in laparoscopic surgery:results of a randomized study[J]. Surgical endoscopy,2016,30(5):1733-1741.
[13]李成林.经脐单孔腹腔镜胆囊切除术对患者血管内皮功能和炎症因子的影响[J].海南医学院学报,2016,22(7):673-676.
[14]闫长红,许艳春.腹腔镜胆囊切除术对患者血清IL-6、IL-10、TNF-α水平的影响[J].宁夏医科大学学报,2016,38(4):469-471.
[15]张成,魏萍,寇巍,等.黄芪对变应性鼻炎患者外周血Th17的影响[J].中国中西医结合杂志,2016,36(11):1364-1368.
[16]陈文彬,唐瑛,王庆敏,等.党参多糖对脑缺血缺氧大鼠血清白细胞介素-1β及肿瘤坏死因子-α水平的影响[J].中华航海医学与高气压医学杂志,2016,23(4):309-311.
[2]贾利猛,杜剑,欧云崧.腹腔镜胆囊切除术对老年胃肠功能恢复及并发症的影响[J].中国现代普通外科进展,2017,20(6):465-467.
[3]Aspinen S,Kinnunen M,Harju J,et al. Inflammatory response to surgical trauma in patients with minilaparotomy cholecystectomy versus laparoscopic cholecystectomy a randomised multicentre study[J]. Scandinavian journal of gastroenterology,2016,51(6):739-744.
[4]初阳.活血行气中药联合镇痛药治疗膝骨关节炎关节镜术后疼痛及对炎性因子影响[J].辽宁中医药大学学报,2017,19(6):207-209.
[5]崔贺华,刘云贺,何笑雨.二氧化碳气腹压对行腹腔镜胆囊切除术患者血流动力学及胃肠功能影响[J].新乡医学院学报,2016,33(4):321-324.
[6]Kim GH,Lee HD,Min K,et al. Fate of Dyspeptic or Colonic Symptoms After Laparoscopic Cholecystectomy[J]. Journal of Neurogastroenterology&Motility,2014,20(2):253-260.
[7]张洵,温达,王伟.单切口腹腔镜胆囊切除术对患者胃肠功能及血清IMA、APN及GAS的影响[J].中国临床研究,2018,31(5):648-652.
[8]董璐.针灸联合运脾饮治疗腹部外科全麻非胃肠术后胃肠功能紊乱疗效观察[J].现代中西医结合杂志,2017,26(28):3126-3128.
[9]王林月,吴伟梁,张立清.柴胡疏肝散合平胃散对腹腔镜胆囊切除术后胃肠功能的影响[J].中国中西医结合外科杂志,2017,23(1):69-71.
[10]葛正息,王晓斌,秦颖.加味大承气汤对高龄结石性胆囊炎患者腹腔镜胆囊切除术后胃肠功能恢复的影响[J].现代中西医结合杂志,2018,27(7):772-775.
[11] Aspinen S,Kinnunen M,Harju J,et al. Inflammatory response to surgical trauma in patients with minilaparotomy cholecystectomy versus laparoscopic cholecystectomy a randomised multicentre study[J]. Scandinavian Journal of Gastroenterology,2016,51(6):1.
[12] Agarwal BB,Nanavati JD,Agarwal N,et al. Biomolecular inflammatory response to surgical energy usage in laparoscopic surgery:results of a randomized study[J]. Surgical endoscopy,2016,30(5):1733-1741.
[13]李成林.经脐单孔腹腔镜胆囊切除术对患者血管内皮功能和炎症因子的影响[J].海南医学院学报,2016,22(7):673-676.
[14]闫长红,许艳春.腹腔镜胆囊切除术对患者血清IL-6、IL-10、TNF-α水平的影响[J].宁夏医科大学学报,2016,38(4):469-471.
[15]张成,魏萍,寇巍,等.黄芪对变应性鼻炎患者外周血Th17的影响[J].中国中西医结合杂志,2016,36(11):1364-1368.
[16]陈文彬,唐瑛,王庆敏,等.党参多糖对脑缺血缺氧大鼠血清白细胞介素-1β及肿瘤坏死因子-α水平的影响[J].中华航海医学与高气压医学杂志,2016,23(4):309-311.