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目的:探讨加味六磨汤治疗妇科恶性肿瘤患者术后肠梗阻的临床疗效。方法:选取妇科恶性肿瘤患者术后肠梗阻72例,随机法分为对照组和治疗组,各36例。两组均予一般对症处理,对照组再予开塞露灌肠,治疗组再予加味六磨汤灌肠治疗。观察两组治疗后首次肛门排气时间及排便时间,比较两组治疗前、术后1 d、5 d时患者血浆胃动素(MLT)及血管活性肠肽(VIP)的变化。评估其生活质量及临床疗效。结果:总有效率对照组69.4%,治疗组88.9%,组间差异有统计学意义(P<0.05)。对照组生活质量改善率、稳定率、恶化率依次为16.7%、50.0%、33.3%,治疗组生活质量改善率、稳定率、恶化率依次为38.9%、50.0%、11.1%;治疗组生活质量改善率高于对照组(P<0.05),而恶化率低于对照组(P<0.05)。治疗组患者首次肛门排气时间及排便时间均明显早于对照组,组间差异有统计学意义(P<0.01)。治疗组血浆MLT水平呈逐渐上升趋势,组内差异有统计学意义(P<0.05);而对照组术后1 d时患者血浆MLT水平呈峰值,分别与同组治疗前、术后5 d比较,差异有统计学意义(P<0.05)。对照组血浆VIP水平呈逐渐上升趋势,组内差异有统计学意义(P<0.05);而治疗组术后1 d时患者血浆MLT水平呈峰值,分别与同组治疗前、术后5 d比较,差异均有统计学意义(P<0.05)。术后5 d治疗组患者血浆MLT水平高于对照组(P<0.05),而VIP水平低于对照组(P<0.05)。结论:加味六磨汤治疗妇科恶性肿瘤患者术后肠梗阻,临床疗效显著,其作用机制可能与调节患者血浆中MLT、VIP水平相关;同时能有效改善患者生活质量。
Objective: To investigate the clinical curative effect of Jiawei Liumao Tang on postoperative intestinal obstruction in patients with gynecological malignancies. Methods: 72 cases of postoperative intestinal obstruction were selected from patients with gynecologic malignancies. The patients were randomly divided into control group and treatment group, with 36 cases in each group. The two groups were given symptomatic treatment, the control group was treated with Kai Leli enema, the treatment group and then Jiawei six mill soup enema treatment. The time of first anal exhaust and defecation were observed after treatment. The changes of plasma motilin (MLT) and vasoactive intestinal peptide (VIP) before and 1 and 5 days after operation were compared between the two groups. Assess their quality of life and clinical efficacy. Results: The total effective rate was 69.4% in the control group and 88.9% in the treatment group, with significant difference between the two groups (P <0.05). The improvement rate, stability rate and quality of life in the control group were 16.7%, 50.0% and 33.3%, respectively. The quality of life improvement rate, stability rate and deterioration rate in the treatment group were 38.9%, 50.0% and 11.1%, respectively. The quality of life The improvement rate was higher than that of the control group (P <0.05), but the rate of deterioration was lower than that of the control group (P <0.05). In the treatment group, the time of first anal exhaust and defecation were significantly earlier than that of the control group, with significant difference between the two groups (P <0.01). The level of plasma MLT increased gradually in the treatment group, with significant difference between the two groups (P <0.05). In the control group, the level of plasma MLT peaked at 1 day after operation, compared with the same group before and after 5 days , The difference was statistically significant (P <0.05). The level of plasma VIP in the control group showed a gradual upward trend with a significant difference between the two groups (P <0.05). However, the level of plasma MLT peaked at 1 d after operation in the treatment group, compared with that before treatment and 5 days after operation , The differences were statistically significant (P <0.05). The level of plasma MLT in the patients on the 5th postoperative day was higher than that in the control group (P <0.05), while the VIP level was lower than that of the control group (P <0.05). Conclusion: Modified Liu mill decoction in the treatment of postoperative intestinal obstruction in patients with gynecologic malignancies has obvious curative effect. The mechanism may be related to the regulation of MLT and VIP in the plasma of patients with gynecologic malignancies. At the same time, it can effectively improve the quality of life of patients.