本文關(guān)鍵詞： 電針 足三里 上巨虛 下巨虛 腹腔鏡術(shù)后 胃腸動力　出處：《廣州中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：本課題是通過觀察腹部腹腔鏡術(shù)后首次排氣、排便、腸鳴音恢復(fù)的時間及腹脹、腹痛、惡心嘔吐等反應(yīng)胃腸功能恢復(fù)的指標(biāo),探討電針足三里與電針足三里加上、下巨虛對腹腔鏡下腹部術(shù)后胃腸功能恢復(fù)的有效性及差異性,為優(yōu)化電針選穴提供依據(jù)。方法：從廣東省中醫(yī)院珠海醫(yī)院外科病房選取80例腹部術(shù)后(腹腔鏡術(shù)后)患者,采取隨機對照試驗的方法,將患者分為治療組：電針足三里、上巨虛、下巨虛組和對照組：電針足三里組各40例。兩組病人術(shù)后常規(guī)給予禁食、心電監(jiān)護、低流量給氧、常規(guī)外科護理、術(shù)口TDP燈術(shù)照燈治療、抗感染、補液等治療措施,如病情嚴(yán)重及較大胃腸手術(shù)病人需長期禁食,則給予腸外營養(yǎng)支持等治療方法。兩組病人均加用電針治療,對照組加用電針雙側(cè)足三里,治療組加用電針雙側(cè)足三里、上巨虛、下巨虛,每日電針2次,術(shù)后6小時開始電針治療,并監(jiān)測患者電針前后腸鳴音、惡心嘔吐、腹脹、腹痛等情況；同時對病人的第一次排氣、第一次排便、腸鳴音恢復(fù)時間的時間進行記錄。創(chuàng)建數(shù)據(jù)庫,并且運用SPSS19.0進行統(tǒng)計學(xué)分析。成果：電針足三里、上巨虛、下巨虛組對術(shù)后病人的胃腸動力障礙的治療效果較電針足三里組更為有效,電針足三里、上巨虛、下巨虛組較電針足三里組的腸鳴音恢復(fù)時間、首次排氣時間、首次排便時間均縮短。電針足三里組腸鳴音恢復(fù)時間平均為14.53±2.43h,電針足三里、上巨虛、下巨虛組首次排氣時間平均為12.75±2.18h,兩組之間腸鳴音恢復(fù)時間的差別具有統(tǒng)計學(xué)意義,p＜0.05；電針足三里組首次排氣時間平均為21.53±4.74h,電針足三里、上巨虛、下巨虛組首次排氣時間平均為19.28±4.34h,兩組之間首次排氣時間的差別具有統(tǒng)計學(xué)意義,p＜0.05；電針足三里組首次排便時間平均為27.88+4.69h,電針足三里、上巨虛、下巨虛組首次排便時間平均為24.68±4.00h,兩組之間首次排便時間的差別具有統(tǒng)計學(xué)意義,p＜0.05。兩組之間在性別、年齡、身高、體重等方面經(jīng)T檢驗,均無統(tǒng)計學(xué)意義。兩組之間治療前癥狀評分經(jīng)統(tǒng)計學(xué)分析,p＞0.05,兩組之間的差別無統(tǒng)計學(xué)意義。兩組之間治療后的癥狀評分情況,治療組較對照組的療效更為顯著,兩組之間的差別具有統(tǒng)計學(xué)意義,p＜0.05。結(jié)論：電針足三里聯(lián)合上巨虛、下巨虛對腹部腹腔鏡術(shù)后患者胃腸動力恢復(fù)較單純電針足三里有更加明顯的促進作用,腸鳴音恢復(fù)時間及第一次排氣、排便出現(xiàn)時間提前,術(shù)后癥狀改善更加明顯。
[Abstract]:Objective: to observe the time of recovery of ventral distension, abdominal pain, nausea and vomiting, and to observe the recovery time of ventriculus, defecation, bowel sound and abdominal distension, abdominal pain, nausea and vomiting after abdominal laparoscopy. To explore the effectiveness and difference between electroacupuncture Zusanli and electroacupuncture Zusanli plus Xiabu deficiency in the recovery of gastrointestinal function after laparoscopic abdominal surgery. Methods: 80 patients after abdominal surgery (laparoscopic operation) were selected from the surgical ward of Zhuhai Hospital of traditional Chinese Medicine of Guangdong Province. The patients were divided into treatment group: electroacupuncture Zusanli group, upper Juxu group, lower Juxu group and control group: electroacupuncture Zusanli group (40 cases each). The patients in both groups were given fasting, ECG monitoring, low flow oxygen supply, routine surgical nursing after operation. Surgical mouth TDP lamp light therapy, anti-infection, fluid rehydration and other treatment measures, such as serious illness and large gastrointestinal surgery patients need long-term fasting. Two groups of patients were treated with electroacupuncture, the control group with electroacupuncture bilateral Zusanli, the treatment group with electric acupuncture bilateral Zusanli, the treatment group with bilateral Zusanli, the upper giant asthenia, the lower giant asthenia, 2 times daily electroacupuncture. The patients were treated with electroacupuncture at 6 hours after operation. The patients were monitored for bowel sounds, nausea and vomiting, abdominal distension and abdominal pain before and after electroacupuncture. At the same time, the patient's first exhaust, the first defecation, bowel sound recovery time to record. Create a database, and use SPSS19.0 for statistical analysis. Results: electroacupuncture Zusanli. The treatment of gastrointestinal motility disorder was more effective in the upper and lower giant asthenia group than in the electroacupuncture Zusanli group. The recovery time of the bowel sounds in the electroacupuncture Zusanli group, the upper giant asthenia group and the lower giant asthenia group was longer than that in the electroacupuncture Zusanli group. The time of first venting and the time of first defecation were all shortened. The recovery time of bowel sound in electroacupuncture Zusanli group was 14.53 鹵2.43 h, and electroacupuncture in Zusanli, Shangjuxu. The average initial exhaust time of Xiazhuxu group was 12.75 鹵2.18 h, and the difference between the two groups was statistically significant (P < 0.05). The mean initial exhaust time of electroacupuncture Zusanli group was 21.53 鹵4.74 h, that of electroacupuncture Zusanli group was 19.28 鹵4.34 h. The difference of the first exhaust time between the two groups was statistically significant (p < 0.05). The mean first defecation time of electroacupuncture Zusanli group was 27.88 4.69 h, that of electroacupuncture Zusanli group was 24.68 鹵4.00 h, that of Zusanli group was 24.68 鹵4.00 h. The difference of the first defecation time between the two groups was statistically significant (P < 0.05). The sex, age, height and weight of the two groups were tested by T test. There was no statistical significance between the two groups. The scores of symptoms before treatment between the two groups were statistically analyzed (p > 0.05), and the difference between the two groups was not statistically significant, and the scores of symptoms after treatment between the two groups were not statistically significant. The curative effect of the treatment group was more significant than that of the control group, the difference between the two groups was statistically significant (p < 0.05). Conclusion: electroacupuncture Zusanli combined with Shangjuxu. The recovery of gastrointestinal motility after abdominal laparoscopy was more obvious than that of electroacupuncture in Zusanli patients. The recovery time of bowel sound and the first time of exhaust and defecation appeared earlier. The improvement of postoperative symptoms was more obvious.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R656

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