摘要
目的 探讨砭石穴位按摩联合半夏厚朴汤加减治疗经皮椎体成形术后麻痹性肠梗阻的疗效.方法 前瞻性选取2022年9月至2023年8月在武汉市中医医院进行经皮椎体成形术后发生麻痹性肠梗阻患者,共80例,按照随机数字表法将其分为试验组和对照组,每组各40例.2组均给予常规治疗,对照组在常规治疗基础上给予半夏厚朴汤加减,观察组在对照组基础上加用砭石穴位按摩.比较2组患者的平均治疗时间、疗效、胃肠功能恢复时间和腹痛腹胀缓解时间,比较2组治疗前后血清胃肠激素水平、焦虑和抑郁程度.结果 试验组平均治疗时间为(4.52±1.85)d,显著少于对照组[(7.56±3.50)d],差异有统计学意义(P＜0.05).试验组的治疗总有效率为95.00％,高于对照组(80.00％),差异有统计学意义(P＜0.05).试验组的首次肛门排气时间、肠鸣音恢复时间、首次耐受固体食物时间、首次排便时间、腹痛腹胀缓解时间分别为(23.21±6.78)h、(17.56±7.28)h、(6.57±1.28)h、(34.35±10.31)h、(2.65±0.75)d,均短于对照组[(40.79±12.89)h、(35.18±10.34)h、(8.02±1.35)h、(47.68±12.45)h、(5.70±1.35)d],差异均有统计学意义(P＜0.05).治疗后,2组患者的血清胃动素、胃泌素、P物质水平均高于治疗前,且试验组患者的血清胃动素、胃泌素、P物质水平分别为(218.38±14.95)、(290.52±12.93)、(111.63±18.73)ng/L,均高于对照组[(180.60±17.63)、(231.60±14.25)、(94.86±15.46)ng/L],差异均有统计学意义(P＜0.05).治疗后,2组患者的SAS、SDS评分均较治疗前降低,且试验组SAS、SDS评分分别为(42.98±4.63)、(43.61±5.12)分,均低于对照组[(56.86±5.02)、(54.63±5.87)分],差异均有统计学意义(P＜0.05).结论 砭石穴位按摩联合半夏厚朴汤加减治疗经皮椎体成形术后麻痹性肠梗阻疗效显著,具有治疗天数少、胃肠功能恢复时间和腹痛腹胀缓解时间短、提高血清胃肠激素水平、加强胃肠功能动力、减轻患者的焦虑和抑郁程度的优势.
Abstract
Objective To investigate the curative effect of Needle Stone acupoint massage combined with Banxia Houpu Decoction in the treatment of paralytic intestinal obstruction after percutaneous vertebroplasty.Methods A total of 80 patients with paralytic intestinal obstruction after percutaneous vertebroplasty in Wuhan Hospital of Traditional Chinese Medicine from September 2022 to August 2023 were prospectively se-lected and divided into the experimental group and the control group according to the random number table method,with 40 cases in each group.Both groups were given conventional treatment,the control group was given Banxia Houpu Decoction on the basis of conventional treatment,the ob-servation group was given Needle Stone acupoint massage on the basis of the control group.The average treatment days,therapeutic efficacy,gas-trointestinal function recovery time and abdominal pain and abdominal distension relief time of the two groups were compared.The levels of serum gastrointestinal hormones,anxiety and depression levelsofthe patient's before and after treatment were compared between the two groups.Results The average treatment days of the experimental group was(4.52±1.85)d,which was significantly less than that of the control group[(7.56±3.50)d],and the difference was statistically significant(P＜0.05).The total effective rate of treatment in the experimental group was 95.00％,which was higher than that in the control group(80.00％),and the difference was statistically significant(P＜0.05),The time of first anal ex-haust,the time of intestinal sound recovery,the time of first solid food tolerance,the time of first defecation and the time of abdominal pain and distension relief were(23.21±6.78)h,(17.56±7.28)h,(6.57±1.28)h,(34.35±10.31)h,(2.65±0.75)d,respectively,which were shorter than those in the control group[(40.79±12.89)h,(35.18±10.34)h,(8.02±1.35)h,(47.68±12.45)h and(5.70±1.35)d],and the differences were statistically significant(P＜0.05).After treatment,the levels of serum motilin,gastrin,Substance P in both groups were higher than those before treatment,the levels of serum motilin,gastrin,Substance P in experimental group were(218.38±14.95),(290.52±12.93),and(111.63±18.73)ng/L,respectively,which were higher than those in the control group[(180.60±17.63),(231.60±14.25)and(94.86±15.46)ng/L],and the differences were statistically significant(P＜0.05).After treatment,the scores of SAS and SDS in the two groups were decreased when compared with those before treatment,and the scores of SAS and SDS in the experi-mental group were(42.98±4.63)and(43.61±5.12)points,respectively,which were lower than those in the control group[(56.86±5.02)and(54.63±5.87)points],and the differences were statistically significant(P＜0.05).Conclusion Needle Stone acupoint massage com-bined with Banxia Houpu Decoction is effective in the treatment of paralytic intestinal obstruction after percutaneous vertebroplasty.It has the ad-vantages of fewer treatment days,shorter recovery time of gastrointestinal function,shorter relief time of abdominal pain and distension,higher ser-um gastrointestinal hormone level,enhanced gastrointestinal functional power,and reduced anxiety and depression.
维普
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