加减运脾饮促进剖宫产术后康复的临床观察
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摘要
[目的]
在运脾饮治疗妇科术后诸症的前期研究基础之上,观察加减运脾饮促进剖宫产术后胃肠功能恢复、乳汁分泌、子宫复旧等症状的临床疗效和安全性,为促进剖宫产术后康复增加多一种有效、经济、安全的方法,并希望在临床得以推广,促进剖宫产术后恢复以及婴幼儿的健康成长。
【方法】
本文在前期临床研究的基础上,选取广州市越秀区妇幼保健院产科住院部产妇100例(纳入标准和排除标准),经过简单随机化的分组方法,将手术日期为奇数者为观察组(50例),偶数者则为对照组(50例)。在同等术后常规处理条件下,分别予以口服加减运脾饮和温开水,观察并对比各组产妇术后腹胀情况、肛门排气及排便时间、初乳出现时间以及乳汁分泌量、恶露持续时间、体温、舌象以及肝功、肾功等临床观察指标,经过相关的统计分析(SPSS13.0软件包),以证实加减运脾饮在促进剖宫产术后康复的有效性和安全性。
【结果】
(1)100例产妇中观察组平均年龄为29.24±3.78(岁),对照组平均年龄为30.51±3.12(岁),经t检验,P>0.05,提示无显著性差异,具有可比性。
(2)观察组和对照组于产后1天经症状自评量表打分,分别是13.43±1.58,13.26±1.37,经t检验,P>0.05,两组自评症状得分无明显差异,具有可比性。
(3)两组产妇中,服用加减运脾饮的观察组在胃肠功能恢复时间、自主功能恢复时间、初乳出现时间以及恶露持续时间方面都比对照组要短。
(4)治疗剖宫产术后主要症状的临床疗效,观察组显效13例,有效22例,好转11例,无效4例,总有效率92%；对照组显效3例,有效12例,好转20例,无效15例,总有效率70%。观察组初乳出现的平均时间为24.04±6.46(小时),对照组初乳出现的平均时间为31.53±7.61(小时)。观察组恶露持续的平均时间为19.57±5.8(天),对照组恶露持续的平均时间为17.72±6.25(天)。分别用卡方检验和t检验,P<0.05,提示加减运脾饮能促进剖宫产术后胃肠功能恢复、初乳的出现以及子宫的复旧。
(5)术后第1天,观察组的谷丙转氨酶(ALT)和谷草转氨酶(AST)分别是27.12±7.8549(IU/L),21.34±6.3023(IU/L)；尿素氮(UA)和肌苷(CR)分别是5.3680±1.1786(mmol/L),68.5800±15.8344(umol/L).术后第4天,观察组的ALT和AST分别是26.54±7.3491(IU/L),19.71±6.5458(IU/L)；UA和CR分别是5.0520±1.1003(mmol/L),69.8100±15.2466(umol/L).经t检验,P>0.05,提示观察组在服药前后肝肾功能无显著性差异,其余血常规、尿常规和心电图在用药前后未见异常,说明加减运脾饮临床用药安全可靠。
【结论】
(1)临床观察提示,加减运脾饮在促进剖宫产术后康复方面有较好的临床疗效,与对照组相比有显著性统计学意义。
(2)本研究初步提示加减运脾饮具有有效、经济、安全的优点,值得进一步扩大样本含量进行多中心、大样本的临床研究,为推广中医药在促进剖宫产术后康复的临床应用方面提供依据。
Based on the preliminary studies of Yunpiyin in the treatment of gynecological surgery postoperative complications, it is to observe the clinical efficacy and drug safety of the modification of Yunpiyin in promoting restoration of the gastrointestinal function、milk-secretion、involution uterus etc. It adds an extra efficient、economical and safe way to promote the recovery of cesarean section. It is hoped to be popularized in clinical to promote recovery of the patient from cesarean section and infant's healthy growth.
Methods
In this study, on the early clinical research basis, it selects 100 cases from Maternity and child Health Hospital obstetrical in-patient department of Yuexiu district in Guangzhou(inclusion criteria and exclusion criteria).Through a simple randomized grouping method, the surgery date that are odd date are assigned as observation group(50 cases), those are even are assigned as control group(50 cases). Under the same postoperative conventional treatment condition, groups are respectively given oral modification of Yunpiyin and warm water, they are observed and compared by the index of abdominal distension anus flatus and defecation time、colostrum appear time and breast milk secretory volume、lochia duration、temperature、tongue picture and liver function, renal function and other indicators of clinical observation. After relevant statistical analysis(SPSS13.0 software), it is to confirm the effectiveness and safety of modification of Yunpiyin in promoting cesarean section postoperative restoration.
Results
(1) In the 100 cases, the average age of observation group is 29.24±3.78 (years old), that of control group is 30.51±3.12(years old). By the t test (P>0.05), there are no significant differences between the two groups, it is comparable.
(2) One day after delivery, symptom self-rating scores of observation group and control group are respectively 13.43±1.58,13.26±1.37. By t test, trere are no significant differences of the symptom Self-rating score between two groups(P>0.05),it is comparable.
(3) Between the two groups, the treatment group that takes the medicine takes shorter time in respect of recovery of gastrointestinal function, independent function recovery time, the appearance time of colostrum and the duration of lochia than those of the control group.
(4)Among the observation group, there are 13 cases markedly effective,22 cases effective,11 cases experienced improvement,4 cases null and void. The total efficient rate of the clinical efficacy of the treatment is 92%. Among the control group,3 cases markedly effective,12 cases effective,20 cases experienced improvement,15 cases of ineffective, the total effective rate is 70%. The average appearance time of colostrum in the observation group is 24.04±6.46 (h), that in the control group is 31.53±7.61 (h). The average duration of lochia in the observation group is 13.57±5.8(d), the average duration of lochia in the control group is 17.72±6.25 (d). By chi-square test and the t-test respectively (P<0.05), it suggests that the modification of YunPiYin can Promote the recovery of gastrointestinal function after cesarean section, the emergence of colostrum and redintegration of the uterus.
(5) One day after the operation, the ALT and AST of the observation group are respectively 27.12±7.8549(IU/L),21.34±6.3023(IU/L);The UA and CR are respectively 5.3680±1.1786(mmol/L),68.5800±15.8344(umol/L). Four days after the operation, the ALT and AST of the observation group are respectively 26.54±7.3461(IU/L),19.71±6.5458(IU/L);The UA and CR are respectively 5.0520±1.1003(mmol/L),69.8100±15.2466(umol/L). By t-test, P>0.05, it prompts the observation group that the liver and kidney function is of no significant difference before and after the surgery, the rest of routine urine、blood test and electrocardiogram didn't have any abnormal symptons before and after meditation, demonstrating that the clinical medication of Yunpiying is secure.
Conclusion
(1) Clinical observation suggests that modification of Yunpiyin has a better efficiency in promoting cesarean section postoperative restoration of patients. Compared with the control group, it is of great statistical significance.
(2) This study preliminarily promotes that the modification of Yunpiyin is effective, economical and safe, it is worth to further expand the sample size, multi-center, large sample of clinical research. It provides a basis for popularizing Chinese medicine in promoting restoration of cesarean section postoperative complications in clinical application. v
在运脾饮治疗妇科术后诸症的前期研究基础之上,观察加减运脾饮促进剖宫产术后胃肠功能恢复、乳汁分泌、子宫复旧等症状的临床疗效和安全性,为促进剖宫产术后康复增加多一种有效、经济、安全的方法,并希望在临床得以推广,促进剖宫产术后恢复以及婴幼儿的健康成长。
【方法】
本文在前期临床研究的基础上,选取广州市越秀区妇幼保健院产科住院部产妇100例(纳入标准和排除标准),经过简单随机化的分组方法,将手术日期为奇数者为观察组(50例),偶数者则为对照组(50例)。在同等术后常规处理条件下,分别予以口服加减运脾饮和温开水,观察并对比各组产妇术后腹胀情况、肛门排气及排便时间、初乳出现时间以及乳汁分泌量、恶露持续时间、体温、舌象以及肝功、肾功等临床观察指标,经过相关的统计分析(SPSS13.0软件包),以证实加减运脾饮在促进剖宫产术后康复的有效性和安全性。
【结果】
(1)100例产妇中观察组平均年龄为29.24±3.78(岁),对照组平均年龄为30.51±3.12(岁),经t检验,P>0.05,提示无显著性差异,具有可比性。
(2)观察组和对照组于产后1天经症状自评量表打分,分别是13.43±1.58,13.26±1.37,经t检验,P>0.05,两组自评症状得分无明显差异,具有可比性。
(3)两组产妇中,服用加减运脾饮的观察组在胃肠功能恢复时间、自主功能恢复时间、初乳出现时间以及恶露持续时间方面都比对照组要短。
(4)治疗剖宫产术后主要症状的临床疗效,观察组显效13例,有效22例,好转11例,无效4例,总有效率92%；对照组显效3例,有效12例,好转20例,无效15例,总有效率70%。观察组初乳出现的平均时间为24.04±6.46(小时),对照组初乳出现的平均时间为31.53±7.61(小时)。观察组恶露持续的平均时间为19.57±5.8(天),对照组恶露持续的平均时间为17.72±6.25(天)。分别用卡方检验和t检验,P<0.05,提示加减运脾饮能促进剖宫产术后胃肠功能恢复、初乳的出现以及子宫的复旧。
(5)术后第1天,观察组的谷丙转氨酶(ALT)和谷草转氨酶(AST)分别是27.12±7.8549(IU/L),21.34±6.3023(IU/L)；尿素氮(UA)和肌苷(CR)分别是5.3680±1.1786(mmol/L),68.5800±15.8344(umol/L).术后第4天,观察组的ALT和AST分别是26.54±7.3491(IU/L),19.71±6.5458(IU/L)；UA和CR分别是5.0520±1.1003(mmol/L),69.8100±15.2466(umol/L).经t检验,P>0.05,提示观察组在服药前后肝肾功能无显著性差异,其余血常规、尿常规和心电图在用药前后未见异常,说明加减运脾饮临床用药安全可靠。
【结论】
(1)临床观察提示,加减运脾饮在促进剖宫产术后康复方面有较好的临床疗效,与对照组相比有显著性统计学意义。
(2)本研究初步提示加减运脾饮具有有效、经济、安全的优点,值得进一步扩大样本含量进行多中心、大样本的临床研究,为推广中医药在促进剖宫产术后康复的临床应用方面提供依据。
Based on the preliminary studies of Yunpiyin in the treatment of gynecological surgery postoperative complications, it is to observe the clinical efficacy and drug safety of the modification of Yunpiyin in promoting restoration of the gastrointestinal function、milk-secretion、involution uterus etc. It adds an extra efficient、economical and safe way to promote the recovery of cesarean section. It is hoped to be popularized in clinical to promote recovery of the patient from cesarean section and infant's healthy growth.
Methods
In this study, on the early clinical research basis, it selects 100 cases from Maternity and child Health Hospital obstetrical in-patient department of Yuexiu district in Guangzhou(inclusion criteria and exclusion criteria).Through a simple randomized grouping method, the surgery date that are odd date are assigned as observation group(50 cases), those are even are assigned as control group(50 cases). Under the same postoperative conventional treatment condition, groups are respectively given oral modification of Yunpiyin and warm water, they are observed and compared by the index of abdominal distension anus flatus and defecation time、colostrum appear time and breast milk secretory volume、lochia duration、temperature、tongue picture and liver function, renal function and other indicators of clinical observation. After relevant statistical analysis(SPSS13.0 software), it is to confirm the effectiveness and safety of modification of Yunpiyin in promoting cesarean section postoperative restoration.
Results
(1) In the 100 cases, the average age of observation group is 29.24±3.78 (years old), that of control group is 30.51±3.12(years old). By the t test (P>0.05), there are no significant differences between the two groups, it is comparable.
(2) One day after delivery, symptom self-rating scores of observation group and control group are respectively 13.43±1.58,13.26±1.37. By t test, trere are no significant differences of the symptom Self-rating score between two groups(P>0.05),it is comparable.
(3) Between the two groups, the treatment group that takes the medicine takes shorter time in respect of recovery of gastrointestinal function, independent function recovery time, the appearance time of colostrum and the duration of lochia than those of the control group.
(4)Among the observation group, there are 13 cases markedly effective,22 cases effective,11 cases experienced improvement,4 cases null and void. The total efficient rate of the clinical efficacy of the treatment is 92%. Among the control group,3 cases markedly effective,12 cases effective,20 cases experienced improvement,15 cases of ineffective, the total effective rate is 70%. The average appearance time of colostrum in the observation group is 24.04±6.46 (h), that in the control group is 31.53±7.61 (h). The average duration of lochia in the observation group is 13.57±5.8(d), the average duration of lochia in the control group is 17.72±6.25 (d). By chi-square test and the t-test respectively (P<0.05), it suggests that the modification of YunPiYin can Promote the recovery of gastrointestinal function after cesarean section, the emergence of colostrum and redintegration of the uterus.
(5) One day after the operation, the ALT and AST of the observation group are respectively 27.12±7.8549(IU/L),21.34±6.3023(IU/L);The UA and CR are respectively 5.3680±1.1786(mmol/L),68.5800±15.8344(umol/L). Four days after the operation, the ALT and AST of the observation group are respectively 26.54±7.3461(IU/L),19.71±6.5458(IU/L);The UA and CR are respectively 5.0520±1.1003(mmol/L),69.8100±15.2466(umol/L). By t-test, P>0.05, it prompts the observation group that the liver and kidney function is of no significant difference before and after the surgery, the rest of routine urine、blood test and electrocardiogram didn't have any abnormal symptons before and after meditation, demonstrating that the clinical medication of Yunpiying is secure.
Conclusion
(1) Clinical observation suggests that modification of Yunpiyin has a better efficiency in promoting cesarean section postoperative restoration of patients. Compared with the control group, it is of great statistical significance.
(2) This study preliminarily promotes that the modification of Yunpiyin is effective, economical and safe, it is worth to further expand the sample size, multi-center, large sample of clinical research. It provides a basis for popularizing Chinese medicine in promoting restoration of cesarean section postoperative complications in clinical application. v
引文
[1]乐杰.妇产科学[M].第7版.北京：人民卫生出版社,2004.82、83、124.
[2]李承业.剖宫产后诸症辨治3则[J].新中医,2006,38(8)：87-88.
[3]李坤寅,刘宇权,岳炜.运脾饮治疗妇科腹部术后诸症临床观察[J].新中医,2001,33(8)：18—19.
[4]张希臣,刘玉辉.术后功能性胃肠排空障碍研究[J].武警医学,2008,6：545.
[5]陆英杰,连至诚.胃肠激素对胃肠动力的影响[J].中国热带医学,2005,5(6)：1338-1339.
[6]解基良,何清宇,薛文斗.大承气汤冲剂术后早期使用的临床观察[J].中国中西医结合外科杂志,2006,6(6)：386.
[7]薛富平.腹部手术后早期补钾对促进胃肠功能恢复的临床分析[J].实用医技杂志,2008,3(15)：900.
[8]Woolf CJ,Chong MS. Preemptive analge sia2treating post2operative pain by preventing the establishment of central sensitization[J]. Ane st h Analg,1993, 77 (2):362.
[9]曹泽毅.中华妇产科学[M].人民卫生出版社,2003.837.
[10]李晓勤,张瑛,孙江川等.剖宫产与自然分娩子宫复旧情况的比较[J].重庆医科大学学报,2009,34(5)：640-642.
[11]戈花妮,黄晓戈,康燕.不同分娩、喂养方式对子宫复旧的影响.山东医药,2005,45(8)：52.
[12]陈玛利,张瑞珍.足月顺产与剖宫产产妇母乳喂养情况比较[J].咸宁医学院学报,1999,13(3)：193—194.
[13]王震,孙启玲.多潘立酮口服液用于剖宫产术后促排气的临床观察[J].山东医
药,2004,44(21)：74.
[14]侯玉琦,崔小霞,李会霞.氯化钾缓释片口服在剖宫产术后胃肠功能恢复的疗效观察及护理[J].中国医药导报,2007,5(15)：80.
[15]Hansen CT. Effect of laxatives on gastrointestinal functional recovery in fast-track hysterectomy:adouble-blind. placebo-controlled randomized study[J].AmJ Obstet Gynecol,2007,196:311-317.
[16]马冬惠,张建青.胃复安与新斯的明预防剖宫产术后胃肠反应及胃肠功能紊乱[J].河北中西医结合杂志,1995,4(2)：47.
[17]何从科,王其杰,杨峰等.红霉素静脉滴注促进腹部手术后肠功能恢复30例临 床分析[J].黔南民族医专学报,2000,3(1)：9210.
[18]张玉花,吴礼生,黄昭穗等.维生素B1在妇科腹部手术后的应用[J].中国新药与临床杂志,2001,20(4)：288-289.
[19]Holte K.Fluid therapy and surgical outcomes in electivesurgery:a need for reassessment in fast-track surgery[J].J Am Coll Surg,2006,202:9712989.
[20]朱宝菊.术后镇痛泵加新斯的明对胃肠功能影响[J].医药论坛杂志,2006,27(2)：627.
[21]马宪丽.剖宫产术后促进肛门排气方法的探讨[J].当代护士,2006,9：35237.
[22]梁俊华,高阗,韩巍巍等.咀嚼口香糖促进剖宫产术后胃肠动力恢复的临床观察[J].同济大学学报,2007,28(2)：81-83.
[23]孔梅青.剖宫产术前补钙防治宫缩乏力性产后出血的临床观察[J].医学信息,2010,(23)2：483-484.
[24]拉日措.卡孕栓舌下用药对剖宫产产后出血量的临床观察[J].青海医药杂志,2008,38(8)：36-37.
[25]李金凤.米索前列腺醇联合缩宫素预防剖宫产后出血[J].湖南外科学杂志,2010,16(3)：94-95.
[26]赖慧超,吕岚.卡孕栓在剖宫产术中预防产后出血应用的临床观察[J].江西医药,2010,45(9)：912-913.
[27]叶海琼.米索前列醇配伍催产素预防剖宫产后出血的应用[J].国际医药医生导报,2010,16(20)：2511-2512.
[28]尹维,陈欣,何芳等.卡前列甲酯栓预防剖宫产术后出血400例临床观察[J].当代医学,2009,15(24)：57-58.
[29]杨素勉,桑文淑,纪彩卿等.低频电流治疗对促进剖宫产产妇泌乳及子宫复旧的影响[J].中国康复,2006,21(2):108.
[30]李婵.剖宫产术后康复治疗临床分析[J].当代医学,2009,15(21)：35-36.
[31]张红翠,任国桥,汪永兰.剖宫产术后康复综合治疗仪催乳疗效观察[J].现代中西医结合杂志,2007,16(26)：3817.
[32]曹继红.剖宫产术后产后康复治疗仪对产妇康复的影响[J].临床医学,2009,29(6)：79.
[33]李淑英.产后康复治疗对剖宫产术后泌乳的影响[J].中外医疗,2010,29(32)：53.
[34]周剑利,韩素新,赵芳菲.补气下乳方对剖宫产术后肠蠕动及乳汁分泌的影响[J].陕西中医,2010,31(3)：268-269.
[35]潘佩光,冯虹,黄敏等.“术前体质辨证、术后快速康复”的模式在剖宫产的临床应用[J].广州中医药大学学报,2008,25(2)：103-105.
[36]李西云,付延林.复元下乳饮对剖宫产妇泌乳量、泌乳素、肠蠕动、子宫复旧的影响[J].中国中医药信息杂志,2008,15(9)：68-69.
[37]邵菊珍.中西医结合治疗剖宫产术后腹胀82例疗效观察[J].中华现代临床医学杂志,2006,4(3)：172.
[38]夏淑芳,邹卫兵,廖朝青.加味生化汤对剖宫产术后功能恢复的临床观察[J].光明中医,2009,24(7)：1283-1284.
[39]李道成,许丽绵,邓高丕.平胃散促进宫颈癌根治术后胃肠功能恢复的临床研究[J].新中医,2008,40(3)：20-21.
[40]杨素勉,王亚珍,乔淑章等.低频电流结合穴位按摩对剖宫产产妇肠功能恢复的疗效观察[J].中国康复,2008,23(1)：36-37.
[41]庄春霞、麦今宝、李燕红.加味平胃散促进再次剖宫产术后恢复的疗效观察[J].光明中医,2010,25(7)：1171-1172.
[42]殷勇,唐珊玲等.生乳合剂对产妇血清、乳汁PRL水平的影响[J].放射免疫学杂志,2005,18(6)：467-468.
[43]李红瑜.小承气汤加味促进剖宫产术后胃肠功能恢复80例[J].国医论坛,2006,21(2)：9.
[44]张新培.四磨汤口服液用于剖宫产术后肠功能恢复临床观察[J].中国社区医师：医学专业,2008,10(15)：54-55.
[45]郑重,林茂恩.四磨汤治疗剖宫产术后腹胀疗效观察[J].现代中西医结合杂志,2007,16(33)：4949-4950.
[46]裴正月.四磨汤口服液促进剖宫产术后肠功能恢复的临床观察[J].时珍国医国药,2006,17(6)：1042-1043.
[47]胡长珍,张合会.中药排气汤促进剖宫产病人术后肛门排气的临床观察[J].湖北预防医学杂志,2002,13(4)：63.
[48]王秀霞.中药敷脐治疗剖宫产术后腹胀疗效观察及护理[J].中医误诊学杂志,2006,6(12)：2300-2301.
[49]江苗琴.穴位按摩联合腹部按摩对剖宫产术后肠蠕动的影响[J].护理与康复,2008,7(10)：778-779.
[50]匡晓梅,郑杏珊,黄华勇.按摩对促进产褥期妇女康复的价值分析[J].中国基层医药,2007,14(7)：1128-1129.
[51]刘英,褚娟.足底按摩减轻剖宫产术后疼痛100例[J].中国民间疗法,2005,13(7)：20-21.
[52]陈萍虞.中药足浴配合中药敷脐促进剖宫产术后肛门排气的疗效观察[J].广西医学,2010,32(7)：947-849.
[53]张炳熙,丁斌,任蓉等.耳穴压迫对硬膜外吗啡镇痛病人血浆胃动素及术后胃肠 功能恢复的影响[J].中华麻醉学杂志,1998,18(3)：186-187.
[54]元凤宵.中药排气汤配合敷脐治疗剖宫产手术后肠胀气疗效观察[J].中药误诊学杂志,2009,(10)：2345-2346.
[55]王金云,耿靓羽,周卫东.足三里穴按摩对剖宫产术后产妇肠功能恢复的影响[J].医学理论与实践,2003,16(8)：943-944.
[56]魏庆云,石元刚.剖宫产术后早期食用蓖麻油煎蛋的临床观察[J].中国妇幼保健,2006,21(4)：467-469.
[57]彭桂芝、黄瑛、廖滔等.温水足浴配合果导口服对促进剖宫产术后肛门排气的研究[J].华厦医学,2005,18(15)：704-705.
[58]马竹云、朱玉莲、董光香.中药足浴与开塞露塞肛对剖宫产后肛门排气临床观察[J].中国当代医药,2009,16(7)：56-57.
[59]刘寒秋.大黄苏打片口服结合早期翻身促进剖宫产病人术后胃肠功[J].实用预防医学,2006,13(3)：710-711.
[60]秦文栋、刘文君.穴位注射对剖宫产术后肠蠕动及乳汁分泌的影响[J].上海针灸杂志,2002,21(4)：18-19.
[61]陈桂英,牛健民,刘国成等.益母草注射液预防剖宫产术中、术后出血的临床研究[J].新中医,2008,40(8)：57-58.
[62]梅全喜,毕焕新.现代中药药理手册[M].北京：中国中压药出版社,1998,205—528.
[63]李坤寅、王慧颖、曾诚等.运脾除湿中药对妇科腹部术后患者MTL、GLU影响的研究[J].中华中医药学刊,2008,26(8)：1625-1628.
[64]李坤寅,吴佩莼,关永格等.运脾除湿中药对妇科腹部术后患者GAS、VIP的影响[J].辽宁中医杂志,2009,36(12)：2055-2058.
[65]吴文源.症状自评量表.中华精神科杂志,1986,19(5)：121-293.
[66]吴少祯等.常见疾病的诊断与疗效判定(标准).北京：中国中医药出版社,1999.305.
[67]沈丕安.中药药理与临床运用[M].北京：人民卫生出版社,2006.95-554.
[68]邬浩杰.丹参的药理作用研究[M].浙江中医药大学学报,2008,32(5)：694.
[2]李承业.剖宫产后诸症辨治3则[J].新中医,2006,38(8)：87-88.
[3]李坤寅,刘宇权,岳炜.运脾饮治疗妇科腹部术后诸症临床观察[J].新中医,2001,33(8)：18—19.
[4]张希臣,刘玉辉.术后功能性胃肠排空障碍研究[J].武警医学,2008,6：545.
[5]陆英杰,连至诚.胃肠激素对胃肠动力的影响[J].中国热带医学,2005,5(6)：1338-1339.
[6]解基良,何清宇,薛文斗.大承气汤冲剂术后早期使用的临床观察[J].中国中西医结合外科杂志,2006,6(6)：386.
[7]薛富平.腹部手术后早期补钾对促进胃肠功能恢复的临床分析[J].实用医技杂志,2008,3(15)：900.
[8]Woolf CJ,Chong MS. Preemptive analge sia2treating post2operative pain by preventing the establishment of central sensitization[J]. Ane st h Analg,1993, 77 (2):362.
[9]曹泽毅.中华妇产科学[M].人民卫生出版社,2003.837.
[10]李晓勤,张瑛,孙江川等.剖宫产与自然分娩子宫复旧情况的比较[J].重庆医科大学学报,2009,34(5)：640-642.
[11]戈花妮,黄晓戈,康燕.不同分娩、喂养方式对子宫复旧的影响.山东医药,2005,45(8)：52.
[12]陈玛利,张瑞珍.足月顺产与剖宫产产妇母乳喂养情况比较[J].咸宁医学院学报,1999,13(3)：193—194.
[13]王震,孙启玲.多潘立酮口服液用于剖宫产术后促排气的临床观察[J].山东医
药,2004,44(21)：74.
[14]侯玉琦,崔小霞,李会霞.氯化钾缓释片口服在剖宫产术后胃肠功能恢复的疗效观察及护理[J].中国医药导报,2007,5(15)：80.
[15]Hansen CT. Effect of laxatives on gastrointestinal functional recovery in fast-track hysterectomy:adouble-blind. placebo-controlled randomized study[J].AmJ Obstet Gynecol,2007,196:311-317.
[16]马冬惠,张建青.胃复安与新斯的明预防剖宫产术后胃肠反应及胃肠功能紊乱[J].河北中西医结合杂志,1995,4(2)：47.
[17]何从科,王其杰,杨峰等.红霉素静脉滴注促进腹部手术后肠功能恢复30例临 床分析[J].黔南民族医专学报,2000,3(1)：9210.
[18]张玉花,吴礼生,黄昭穗等.维生素B1在妇科腹部手术后的应用[J].中国新药与临床杂志,2001,20(4)：288-289.
[19]Holte K.Fluid therapy and surgical outcomes in electivesurgery:a need for reassessment in fast-track surgery[J].J Am Coll Surg,2006,202:9712989.
[20]朱宝菊.术后镇痛泵加新斯的明对胃肠功能影响[J].医药论坛杂志,2006,27(2)：627.
[21]马宪丽.剖宫产术后促进肛门排气方法的探讨[J].当代护士,2006,9：35237.
[22]梁俊华,高阗,韩巍巍等.咀嚼口香糖促进剖宫产术后胃肠动力恢复的临床观察[J].同济大学学报,2007,28(2)：81-83.
[23]孔梅青.剖宫产术前补钙防治宫缩乏力性产后出血的临床观察[J].医学信息,2010,(23)2：483-484.
[24]拉日措.卡孕栓舌下用药对剖宫产产后出血量的临床观察[J].青海医药杂志,2008,38(8)：36-37.
[25]李金凤.米索前列腺醇联合缩宫素预防剖宫产后出血[J].湖南外科学杂志,2010,16(3)：94-95.
[26]赖慧超,吕岚.卡孕栓在剖宫产术中预防产后出血应用的临床观察[J].江西医药,2010,45(9)：912-913.
[27]叶海琼.米索前列醇配伍催产素预防剖宫产后出血的应用[J].国际医药医生导报,2010,16(20)：2511-2512.
[28]尹维,陈欣,何芳等.卡前列甲酯栓预防剖宫产术后出血400例临床观察[J].当代医学,2009,15(24)：57-58.
[29]杨素勉,桑文淑,纪彩卿等.低频电流治疗对促进剖宫产产妇泌乳及子宫复旧的影响[J].中国康复,2006,21(2):108.
[30]李婵.剖宫产术后康复治疗临床分析[J].当代医学,2009,15(21)：35-36.
[31]张红翠,任国桥,汪永兰.剖宫产术后康复综合治疗仪催乳疗效观察[J].现代中西医结合杂志,2007,16(26)：3817.
[32]曹继红.剖宫产术后产后康复治疗仪对产妇康复的影响[J].临床医学,2009,29(6)：79.
[33]李淑英.产后康复治疗对剖宫产术后泌乳的影响[J].中外医疗,2010,29(32)：53.
[34]周剑利,韩素新,赵芳菲.补气下乳方对剖宫产术后肠蠕动及乳汁分泌的影响[J].陕西中医,2010,31(3)：268-269.
[35]潘佩光,冯虹,黄敏等.“术前体质辨证、术后快速康复”的模式在剖宫产的临床应用[J].广州中医药大学学报,2008,25(2)：103-105.
[36]李西云,付延林.复元下乳饮对剖宫产妇泌乳量、泌乳素、肠蠕动、子宫复旧的影响[J].中国中医药信息杂志,2008,15(9)：68-69.
[37]邵菊珍.中西医结合治疗剖宫产术后腹胀82例疗效观察[J].中华现代临床医学杂志,2006,4(3)：172.
[38]夏淑芳,邹卫兵,廖朝青.加味生化汤对剖宫产术后功能恢复的临床观察[J].光明中医,2009,24(7)：1283-1284.
[39]李道成,许丽绵,邓高丕.平胃散促进宫颈癌根治术后胃肠功能恢复的临床研究[J].新中医,2008,40(3)：20-21.
[40]杨素勉,王亚珍,乔淑章等.低频电流结合穴位按摩对剖宫产产妇肠功能恢复的疗效观察[J].中国康复,2008,23(1)：36-37.
[41]庄春霞、麦今宝、李燕红.加味平胃散促进再次剖宫产术后恢复的疗效观察[J].光明中医,2010,25(7)：1171-1172.
[42]殷勇,唐珊玲等.生乳合剂对产妇血清、乳汁PRL水平的影响[J].放射免疫学杂志,2005,18(6)：467-468.
[43]李红瑜.小承气汤加味促进剖宫产术后胃肠功能恢复80例[J].国医论坛,2006,21(2)：9.
[44]张新培.四磨汤口服液用于剖宫产术后肠功能恢复临床观察[J].中国社区医师：医学专业,2008,10(15)：54-55.
[45]郑重,林茂恩.四磨汤治疗剖宫产术后腹胀疗效观察[J].现代中西医结合杂志,2007,16(33)：4949-4950.
[46]裴正月.四磨汤口服液促进剖宫产术后肠功能恢复的临床观察[J].时珍国医国药,2006,17(6)：1042-1043.
[47]胡长珍,张合会.中药排气汤促进剖宫产病人术后肛门排气的临床观察[J].湖北预防医学杂志,2002,13(4)：63.
[48]王秀霞.中药敷脐治疗剖宫产术后腹胀疗效观察及护理[J].中医误诊学杂志,2006,6(12)：2300-2301.
[49]江苗琴.穴位按摩联合腹部按摩对剖宫产术后肠蠕动的影响[J].护理与康复,2008,7(10)：778-779.
[50]匡晓梅,郑杏珊,黄华勇.按摩对促进产褥期妇女康复的价值分析[J].中国基层医药,2007,14(7)：1128-1129.
[51]刘英,褚娟.足底按摩减轻剖宫产术后疼痛100例[J].中国民间疗法,2005,13(7)：20-21.
[52]陈萍虞.中药足浴配合中药敷脐促进剖宫产术后肛门排气的疗效观察[J].广西医学,2010,32(7)：947-849.
[53]张炳熙,丁斌,任蓉等.耳穴压迫对硬膜外吗啡镇痛病人血浆胃动素及术后胃肠 功能恢复的影响[J].中华麻醉学杂志,1998,18(3)：186-187.
[54]元凤宵.中药排气汤配合敷脐治疗剖宫产手术后肠胀气疗效观察[J].中药误诊学杂志,2009,(10)：2345-2346.
[55]王金云,耿靓羽,周卫东.足三里穴按摩对剖宫产术后产妇肠功能恢复的影响[J].医学理论与实践,2003,16(8)：943-944.
[56]魏庆云,石元刚.剖宫产术后早期食用蓖麻油煎蛋的临床观察[J].中国妇幼保健,2006,21(4)：467-469.
[57]彭桂芝、黄瑛、廖滔等.温水足浴配合果导口服对促进剖宫产术后肛门排气的研究[J].华厦医学,2005,18(15)：704-705.
[58]马竹云、朱玉莲、董光香.中药足浴与开塞露塞肛对剖宫产后肛门排气临床观察[J].中国当代医药,2009,16(7)：56-57.
[59]刘寒秋.大黄苏打片口服结合早期翻身促进剖宫产病人术后胃肠功[J].实用预防医学,2006,13(3)：710-711.
[60]秦文栋、刘文君.穴位注射对剖宫产术后肠蠕动及乳汁分泌的影响[J].上海针灸杂志,2002,21(4)：18-19.
[61]陈桂英,牛健民,刘国成等.益母草注射液预防剖宫产术中、术后出血的临床研究[J].新中医,2008,40(8)：57-58.
[62]梅全喜,毕焕新.现代中药药理手册[M].北京：中国中压药出版社,1998,205—528.
[63]李坤寅、王慧颖、曾诚等.运脾除湿中药对妇科腹部术后患者MTL、GLU影响的研究[J].中华中医药学刊,2008,26(8)：1625-1628.
[64]李坤寅,吴佩莼,关永格等.运脾除湿中药对妇科腹部术后患者GAS、VIP的影响[J].辽宁中医杂志,2009,36(12)：2055-2058.
[65]吴文源.症状自评量表.中华精神科杂志,1986,19(5)：121-293.
[66]吴少祯等.常见疾病的诊断与疗效判定(标准).北京：中国中医药出版社,1999.305.
[67]沈丕安.中药药理与临床运用[M].北京：人民卫生出版社,2006.95-554.
[68]邬浩杰.丹参的药理作用研究[M].浙江中医药大学学报,2008,32(5)：694.