本文關(guān)鍵詞：電針足三里對(duì)外科腹部術(shù)后胃腸動(dòng)力恢復(fù)影響的臨床研究　出處：《廣州中醫(yī)藥大學(xué)》2013年碩士論文　論文類(lèi)型：學(xué)位論文

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【摘要】：研究目的 本研究應(yīng)用流行病學(xué)方法,以隨機(jī)對(duì)照為原則進(jìn)行前瞻性研究,探討并科學(xué)系統(tǒng)地評(píng)價(jià)電針足三里促進(jìn)術(shù)后胃腸動(dòng)力恢復(fù)的影響及安全性,并形成技術(shù)操作規(guī)范,便于臨床推廣。 研究方法 選取廣東省中醫(yī)院外五科住院行中等腹部手術(shù)治療患者96例,遵循隨機(jī)對(duì)照的科研設(shè)計(jì)分為對(duì)照組(常規(guī)治療組)48例及試驗(yàn)組(電針足三里組)48例,術(shù)后分別給予基礎(chǔ)治療及基礎(chǔ)治療加電針雙側(cè)足三里,觀察兩組病例術(shù)后胃腸動(dòng)力恢復(fù)的情況。 研究結(jié)果 1、電針足三里對(duì)術(shù)后胃腸動(dòng)力恢復(fù)具有一定的療效,在腸鳴音恢復(fù)、排氣、排便時(shí)間、術(shù)后—出院時(shí)間上均短于空白對(duì)照組,但未顯示統(tǒng)計(jì)學(xué)意義。 2、分層結(jié)果顯示：1)在非單純闌尾及膽囊手術(shù)組、胃腸道手術(shù)組、開(kāi)放手術(shù)組中,兩組間在術(shù)后首次排氣時(shí)間和腸鳴音正常時(shí)間的情況比較上,具有統(tǒng)計(jì)學(xué)意義(PO.05)。在首次排便、飲食時(shí)間比較上,無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；2)而在非胃腸道手術(shù)組、腹腔鏡手術(shù)組兩組對(duì)比上,腸鳴音恢復(fù),排氣,排便,飲食時(shí)間上差異無(wú)統(tǒng)計(jì)學(xué)意義。 3、兩組術(shù)后第一天VIP水平均較術(shù)前顯著升高,與空白組相比,電針足三里組術(shù)后第三天VIP水平顯著低于空白對(duì)照組,具有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。兩組術(shù)后第一天MLT水平較術(shù)前顯著降低,電針足三里組術(shù)后第三天胃動(dòng)素水平顯著低于空白對(duì)照組,具有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。 4、不同觀察時(shí)點(diǎn)胃腸功能恢復(fù)情況分析顯示：1)腹脹情況：在觀察時(shí)點(diǎn)2、4上具有統(tǒng)計(jì)學(xué)差異(P0.05)；其余時(shí)點(diǎn)比較差異無(wú)統(tǒng)計(jì)學(xué)意義；2)腹痛情況：在觀察時(shí)點(diǎn)2、3上具有統(tǒng)計(jì)學(xué)意義(P0.05)；其余時(shí)點(diǎn)比較差異無(wú)統(tǒng)計(jì)學(xué)意義；3)惡心嘔吐情況：各時(shí)點(diǎn)比較差異無(wú)統(tǒng)計(jì)學(xué)意義；4)饑餓感情況：時(shí)點(diǎn)比較差異無(wú)統(tǒng)計(jì)學(xué)意義。 5、安全性情況分析顯示：兩組間在不良事件發(fā)生,退出情況,合并用藥上比較均差異無(wú)統(tǒng)計(jì)學(xué)意義。 結(jié)論 電針足三里對(duì)外科腹部術(shù)后胃腸動(dòng)力恢復(fù)優(yōu)于常規(guī)治療,同時(shí)改善腹部術(shù)后臨床癥狀,特別是對(duì)于傳統(tǒng),開(kāi)放,胃腸道手術(shù)更具療效,縮短住院時(shí)間,患者無(wú)不良反應(yīng),安全性高,可在臨床廣泛推廣。
[Abstract]:research objective
In this study, we applied epidemiological method and randomized controlled trial to conduct a prospective study. We explored and systematically evaluated the effect and safety of electroacupuncture at Zusanli on postoperative gastrointestinal motility recovery, and formed technical operation rules to facilitate clinical promotion.
research method
Guangdong Province Traditional Chinese Medical Hospital hospital for five selected secondary abdominal surgery in patients with 96 cases, follow the scientific research design randomized divided into control group (conventional treatment group) 48 cases and the experimental group (electroacupuncture group) 48 cases, after operation were given basic treatment and basic treatment plus Electroacupuncture bilateral Zusanli, recovery of gastrointestinal motility was observed in the two groups cases after the operation.
Research results
1, electroacupuncture has a certain effect on the recovery of gastrointestinal motility after operation, bowel sound recovery, exhaust, defecation time, postoperative discharge time and were shorter than control group, but showed no statistical significance.
2, the results showed that: 1) in stratified non simple appendectomy and cholecystectomy group, gastrointestinal surgery group and open surgery group, the comparison between the two groups in the time of flatus and bowel sounds of normal time, with statistical significance (PO.05). In the first defecation, diet time, no significant the significance (P0.05); 2) in the non gastrointestinal surgery, laparoscopic surgery group, two group comparison, borborygmus, exhaust, defecation, diet had no significant differences on time.
3, the two groups after the first day of VIP were significantly higher than those before the operation, compared with the control group, third days VIP electroacupuncture group after operation was significantly lower than the control group, there was a statistically significant (P0.05). The first day the level of MLT was significantly lower than preoperative in two group after third days, the levels of motilin in electroacupuncture Zusanli group after operation was significantly lower than the control group, there was a statistically significant (P0.05).
4 different observation point, the recovery of gastrointestinal function analysis showed: 1) abdominal distension: in the observation point 2,4 has statistically significant difference (P0.05); the other time points had no significant difference; 2) abdominal pain in the observation point has statistical significance on 2,3 (P0.05); the other time points had no significant difference; 3) nausea and vomiting: at each time point had no significant difference; 4) hunger: the time difference was not statistically significant.
5, the analysis of the safety situation showed that there was no statistical difference between the two groups in the occurrence of adverse events, the withdrawal of the situation, and the combination of the drugs.
conclusion
Electroacupuncture at Zusanli is better than conventional treatment in the recovery of gastrointestinal motility after surgical abdominal operation, and at the same time, it improves the clinical symptoms after abdominal operation. Especially for traditional open surgery, gastrointestinal surgery is more effective, shorter hospitalization time, no adverse reactions and high safety, and it can be widely promoted in clinical practice.

【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R246

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