本文選題：補(bǔ)腎通淋湯　切入點(diǎn)：婦科腹腔鏡手術(shù)　出處：《南京中醫(yī)藥大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過(guò)觀察補(bǔ)腎通淋湯對(duì)婦科腹腔鏡術(shù)后患者尿管留置時(shí)間及相關(guān)癥狀的影響,探討補(bǔ)腎通淋湯對(duì)促進(jìn)術(shù)后膀胱功能恢復(fù)及體質(zhì)改善方面的臨床療效,為婦科圍手術(shù)期相關(guān)癥狀的中醫(yī)藥干預(yù)提供新思路。 方法：將2013年3月至2014年3月在江蘇省中醫(yī)院住院行擇期腹腔鏡手術(shù),并符合本研究標(biāo)準(zhǔn)的患者60例,按照隨機(jī)數(shù)字表分為中藥治療組(A組)30例和對(duì)照組(B組)30例。A組于術(shù)后6小時(shí)后開(kāi)始服用中藥湯劑補(bǔ)腎通淋湯,6小時(shí)內(nèi)飲完,并于術(shù)后12小時(shí)后開(kāi)始常規(guī)服用,每日一劑,早晚各1次分服,每次200ml,連服3天,術(shù)后保留導(dǎo)尿6小時(shí)后拔除尿管；B組于術(shù)后6小時(shí)流質(zhì)飲食,通便后普通飲食,常規(guī)保留導(dǎo)尿24小時(shí)后拔除尿管,兩組術(shù)后其他常規(guī)處理相同。分別記錄兩組患者拔管后首次小便時(shí)間、拔管后首次排尿后殘余尿量、術(shù)后第3天殘余尿量、小腹墜脹、倦怠乏力等癥狀積分,并于術(shù)后第1天和第3天留取尿液樣本,測(cè)定兩組尿常規(guī)及尿液培養(yǎng)情況。 結(jié)果：1.臨床療效：①術(shù)后拔管后首次排尿時(shí)間,A組明顯小于B(P0.05)。⑦術(shù)后第3天殘余尿量,A組明顯小于B組(P0.05)。③術(shù)后第1天和第3天尿常規(guī)及尿培養(yǎng)積分比較,A組明顯優(yōu)于B組(P0.05)。④術(shù)后第1天和第3天主要癥狀積分及癥狀總積分改善情況,A組明顯優(yōu)于B組(P0.05)。 2.安全性分析：治療過(guò)程中對(duì)治療組30例患者進(jìn)行觀察,未發(fā)現(xiàn)有中毒及不良反應(yīng),安全性指標(biāo)的實(shí)驗(yàn)室檢查結(jié)果前后也無(wú)異常發(fā)現(xiàn)。由此得出：本研究所用的藥物無(wú)明顯毒副作用及不良反應(yīng),對(duì)人體是安全的。 結(jié)論：①補(bǔ)腎通淋湯能夠幫助縮短患者的術(shù)后導(dǎo)尿時(shí)間,減少尿路感染的發(fā)生率。②補(bǔ)腎通淋湯還可以改善患者術(shù)后小便不利、倦怠乏力、尿路刺激癥狀、小腹墜脹等主要不適及相關(guān)伴隨癥狀。③補(bǔ)腎通淋湯可以促進(jìn)婦科腹腔鏡術(shù)后患者膀胱功能的恢復(fù),促進(jìn)患者術(shù)后早日康復(fù)。
[Abstract]:Objective: to observe the effect of Bushen Tonglin decoction on urinary catheter indwelling time and related symptoms after gynecological laparoscopy, and to explore the clinical effect of Bushen Tonglin decoction on promoting the recovery of bladder function and improving physique after operation. To provide a new idea for the intervention of gynecological perioperative symptoms with traditional Chinese medicine (TCM). Methods: from March 2013 to March 2014, selected laparoscopic surgery was performed in Jiangsu Provincial Hospital of traditional Chinese Medicine, and 60 patients met the criteria of this study. According to the random number table, 30 cases in group A and 30 cases in group B were divided into treatment group and control group. Group A began to take traditional Chinese medicine decoction Bushen Tonglin decoction within 6 hours after 6 hours of operation, and began to take it regularly 12 hours after operation, once a day. Morning and evening, 200 ml / time for 3 days, after 6 hours of urinary catheterization, extubation of urethral tube in group B was performed at 6 hours after operation, followed by general diet after defecation, and removal of urinary tube after 24 hours of routine retention of urethral catheterization. The time of first urination after extubation, the amount of residual urine after extubation, the residual urine volume on the third day after extubation, the distension of the lower abdomen, fatigue, and so on were recorded in the two groups. Urine samples were collected on the 1st and 3rd day after operation to determine urine routine and urine culture. Results 1. Clinical curative effect: the first time of urination after extubation in group A was significantly less than that in group A (P 0.05.7). The residual urine volume in group A was significantly lower than that in group B (P 0.05.3) on the 1st and 3rd day after operation. The urine routine and urinary culture score in group A were significantly better than those in group A. On the 1st and 3rd day after operation, the improvement of the main symptom score and the total symptom score in group A was significantly better than that in group B (P 0.05). 2. Safety analysis: during the course of treatment, 30 patients in the treatment group were observed, and no toxic or adverse reactions were found. There were no abnormal findings before and after laboratory examination of safety indexes. It was concluded that the drugs used in this study had no obvious side effects and adverse reactions and were safe to human body. Conclusion Bushen Tonglin decoction can shorten the time of urinary catheterization and reduce the incidence of urinary tract infection. 2 Bushen Tonglin decoction can also improve the symptoms of unfavorable urination, fatigue and irritation of urinary tract. Bushen Tonglin decoction can promote the recovery of bladder function of patients after gynecological laparoscopy and promote the early recovery of patients after operation.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R713

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