本文關(guān)鍵詞：“通腑除滿法”針刺治療腹部手術(shù)后胃癱綜合征的臨床研究　出處：《福建中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 針刺 術(shù)后胃癱綜合征 胃動素 通腑除滿法

【摘要】：目的觀察"通腑除滿法"針刺對腹部手術(shù)后胃癱綜合征患者血清胃動素影響,探討針刺促胃排空的作用機制。方法前瞻性隨機對照研究。從2016年1月至2016年12月于福建醫(yī)科大學(xué)附屬協(xié)和醫(yī)院行腹部手術(shù)的患者中,選取符合納入標(biāo)準的60例術(shù)后胃癱綜合征患者并隨機分為2組,對照組采用甲氧氯普胺藥物治療,試驗組采用針刺治療。分別于治療前后觀察胃腸動力恢復(fù)的時間、平均胃癱主要癥狀指數(shù)總分及整個治療過程中胃腸引流量的變化,并采用雙抗體夾心酶聯(lián)免疫吸附法檢測兩組患者血清胃動素水平的變化。所有關(guān)于統(tǒng)計分析的數(shù)據(jù)均采用SPSS 20.0軟件處理分析:年齡、胃腸動力恢復(fù)時間、平均胃腸引流量及胃癱分級采用兩獨立樣本t檢驗或秩和檢驗;性別、原發(fā)病類型用四格表卡方檢驗或RXC列聯(lián)表卡方檢驗;兩組間平均胃癱主要癥狀指數(shù)總分和血清胃動素水平的比較采用兩獨立樣本t檢驗或秩和檢驗,組內(nèi)比較采用配對樣本t檢驗或秩和檢驗。結(jié)果1、一般資料分析:治療前兩組患者的年齡、性別、原發(fā)病類型及胃癱分級進行比較,差異無統(tǒng)計學(xué)意義(P0.05)。2、胃腸動力恢復(fù)時間:兩組患者胃腸動力恢復(fù)時間比較,差異有統(tǒng)計學(xué)意義(P0.05)。3、平均胃癱主要癥狀指數(shù)總分:兩組治療前后平均胃癱主要癥狀指數(shù)總分比較,差異有統(tǒng)計學(xué)意義(P0.05);兩組治療后平均胃癱主要癥狀指數(shù)總分比較,差異有統(tǒng)計學(xué)意義(P0.05)。4、平均胃腸引流量:兩組患者平均胃腸引流量比較,差異有統(tǒng)計學(xué)意義(P0.05);5、血清胃動素水平:兩組治療前后血清胃動素水平比較,差異有統(tǒng)計學(xué)意義(P0.05);兩組治療后血清胃動素水平比較,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論1、"通腑除滿法"針刺和甲氧氯普胺均能改善腹部手術(shù)后胃癱綜合征患者的臨床癥狀,減少胃腸引流量和縮短治療天數(shù),且"通腑除滿法"針刺在改善臨床癥狀、減少胃腸引流量和縮短治療天數(shù)方面優(yōu)于甲氧氯普胺。2、"通腑除滿法"針刺和甲氧氯普胺均能增加血清胃動素的水平,且"通腑除滿法"針刺的作用優(yōu)于甲氧氯普胺。3、"通腑除滿法"針刺在治療術(shù)后胃癱綜合征更有優(yōu)勢,其機制可能與促進血清胃動素的分泌有關(guān)。
[Abstract]:Objective to observe the effect of acupuncture on serum motilin in patients with gastroparesis syndrome after abdominal operation. To explore the mechanism of acupuncture in promoting gastric emptying. Methods A prospective randomized controlled study was conducted in patients undergoing abdominal surgery from January 2016 to December 2016 in Union Hospital affiliated to Fujian Medical University. Sixty patients with postoperative gastroparesis syndrome who met the inclusion criteria were randomly divided into two groups. The control group was treated with metoclopramide. The experimental group was treated with acupuncture. Before and after treatment, the time of gastrointestinal motility recovery, the mean total score of main symptom index of gastroparesis and the change of gastrointestinal drainage flow were observed before and after treatment. The changes of serum motilin levels were detected by double antibody sandwich enzyme-linked immunosorbent assay (Elisa). All the data of statistical analysis were analyzed by SPSS 20.0 software: age. The recovery time of gastrointestinal motility, the mean gastrointestinal drainage volume and the grade of gastroparesis were examined by two independent samples t-test or rank sum test. Sex, the primary type of disease was tested by four-cell table chi-square test or RXC column Chi-square test. The mean total score of the main symptom index and serum motilin level in the two groups were compared by two independent samples t test or rank sum test, and the matched sample t test or rank sum test were used in the intragroup comparison. Results 1. General data analysis: before treatment, the age, sex, primary disease type and grade of gastroparesis were compared between the two groups. There was no significant difference between the two groups (P 0.05). The recovery time of gastrointestinal motility: the difference between the two groups was statistically significant (P 0.05). Mean total score of main symptom index of gastroparesis: the total score of mean index of main symptoms of gastroparesis before and after treatment was significantly different between the two groups (P 0.05). After treatment, the total scores of the main symptoms of gastroparesis in the two groups were compared, the difference was statistically significant (P 0.05), and the mean gastrointestinal drainage volume: the mean gastrointestinal drainage volume was compared between the two groups. The difference was statistically significant (P 0.05). 5, serum motilin level: the difference of serum motilin level between the two groups before and after treatment was statistically significant (P 0.05). After treatment, the serum motilin levels in the two groups were significantly different (P 0.05). Conclusion 1. Both acupuncture and metoclopramide can improve the clinical symptoms of patients with gastroparesis syndrome after abdominal surgery, reduce gastrointestinal drainage and shorten the treatment days. Both acupuncture and metoclopramide can increase the level of serum motilin. The effect of acupuncture was better than that of metoclopramide. Acupuncture of "Tongfu removing Man method" had more advantages in the treatment of postoperative gastroparesis syndrome, and its mechanism might be related to promoting the secretion of serum motilin.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.2

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