新加黄龙汤防治结直肠癌患者术后炎性肠梗阻临床观察
Clinical Effect of Xinjia Huanglong Decoction in the Prevention and Treatment of Postoperative Inflammatory Ileus in Patients with Colorectal Cancer
  
DOI:
中文关键词:  结直肠癌  新加黄龙汤  炎性肠梗阻  胃肠功能  凝血功能
英文关键词:Colorectal cancer  Xinjia Huanglong Decoction  Inflammatory ileus  Gastrointestinal function  Coagulation function
基金项目:国家自然科学基金项目(81573942)
作者单位
季乔雪,王成阳,余晓琪 安徽医科大学第一附属医院安徽 合肥 230010 
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中文摘要:
      目的 探究新加黄龙汤对结直肠癌(colorectal cancer,CRC)患者术后炎性肠梗阻的防治效果及对患者高凝血状态的影响。方法 将204例行择期手术治疗的CRC患者随机分为常规术后治疗组(对照组)及新加黄龙汤联合治疗组(观察组),每组102例。记录两组术后胃肠功能恢复情况(肠鸣音恢复时间、首次排气时间、首次排便时间、首次进普食时间)、术后4周内炎性肠梗阻发生情况差异,术前和术后1周分别观察两组炎症反应因子降钙素原(procalcitonin,PCT)、超敏C反应蛋白(hypersensitive C- reactive protein, hs- CRP)]、免疫功能(CD4+、CD8+ T细胞水平、CD4+/CD8+ T细胞比值)、凝血功能凝血酶原时间(prothrombin time,PT)、活化部分凝血酶原时间(activated partial prothrombin time,APTT)、D- 二聚体(D- dimer,D- D)]。结果 观察组肠鸣音恢复时间、首次排气时间、首次排便时间、首次进普食时间及术后4周内炎性肠梗阻发生率均低于对照组(P<0.05)。与术前比较,两组术后PCT、hs- CRP及D- D水平均显著升高(P<0.05),对照组手术前后PCT、hs- CRP、D- D差值高于观察组(P<0.05);两组术后CD4+、CD8+T细胞比例和CD4+/CD8+T细胞比值亦显著升高(P<0.05),而观察组手术前后差值显著高于对照组(P<0.05)。两组手术前后PT、APTT比较,差异均无统计学意义(P>0.05)。结论 新加黄龙汤能促进CRC患者术后胃肠功能恢复,减轻术后炎症反应,改善机体免疫功能及凝血功能,避免发生炎性肠梗阻。
英文摘要:
      Objective To investigate the clinical effect of Xinjia Huanglong Decoction in the prevention and treatment of postoperative inflammatory ileus in patients with colorectal cancer (CRC) and its influence on hypercoagulable state. Methods A total of 204 patients with CRC who underwent elective surgery were enrolled and randomly divided into routine postoperative treatment group (control group) and combined Xinjia Huanglong Decoction treatment group (observation group), with 102 patients in each group. The two groups were observed in terms of postoperative recovery of gastrointestinal function (time to first bowel sound, time to first flatus, time to first defecation, and time to first normal diet), incidence rate of inflammatory ileus within 4 weeks after surgery, and inflammatory factors \[procalcitonin (PCT) and hypersensitive C- reactive protein (hs- CRP)\], immune function (CD4+, CD8+, and CD4+/CD8+), and coagulation function \[prothrombin time (PT), activated partial thromboplastin time (APTT), and D- dimer (D- D)\] before surgery and at one week after surgery. Results Compared with the control group, the observation group had significantly shorter time to first bowel sound, time to first flatus, time to first defecation, and time to first normal diet and a significantly lower incidence rate of inflammatory ileus (P<0.05). After surgery, both groups had significant increases in the levels of PCT, hs- CRP, and D- D (P<0.05), and the control group had significantly greater increases than the observation group (P<0.05); both groups had significant increases in the percentages of CD4+ and CD8+ T cells and CD4+/CD8+ ratio (P<0.05), and the observation group had significantly greater increases than the control group (P<0.05). There were no significant changes in PT and APTT after surgery in either group (P>0.05). Conclusion In patients with CRC, Xinjia Huanglong Decoction can promote postoperative recovery of gastrointestinal function, alleviate postoperative inflammatory response, improve immune function and coagulation function, and avoid inflammatory ileus.
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