The Efficacy Of Fennel Ironing Method On The Recovery Of Gastrointestinal Function After Gastroenterostomy In Fast Track Surgery

Objective1.To evaluate the efficacy of fennel ironing method on accelerating the recovery of gastrointestinal function after gastroenterostomy.2.To determine the effect of fennel on the spontaneous contraction of murine colon smooth muscle strips in vitro and to investigate its possible mechanism.Methods1.From January to October 2016,192 patients after gastroenterostomy in Zhongnan Hospital of Wuhan University were enrolled and divided into two groups according to whether laparoscopic surgery was performed.Subjects in each group were assigned into experimental group and control group.In experimental groups,patients performed fennel ironing method and conventional fast-track care,while in control groups,heated towel therapy took place of fennel.The baseline characteristics,time to postoperative first flatus(FFL)and first feces(FFE),fasting time,length of postoperative hospital stay,abdominal pain grading,abdominal distension classification,inflammation markers and nutritional status indicators were compared within four groups.2.The colon longitudinal smooth muscle strips of rats were suspended in issue chambers containing 10mL Krebs solution at 3 7 ℃ and their spontaneous contractions.First,we observed the effects of fennel onthe spontaneous contraction of colon smooth muscle strips using sodium chloride(9g/L)(NS)as control.We also investigated the impacts on fennel induced contraction of three different antagonists,verapamil,phentolamine and atropine,respectively with fennel alone as control.Results1.There was a significantly shorter hospital stay time,FFL time and the fasting time in fennel ironing method groups compared with heated towel therapy groups.And abdominal distension was also obviously relieved in fennel ironing method groups.No benefit of fennel ironing method was observed according to the levels of inflammation markers(WBC,MEUT)and nutritional status indicators(HGB,ALB and LYM)in fennel ironing method groups.2.In the study,fennel showed dose-dependent promotive effects on the spontaneous contraction of colon smooth muscle strips in vitro at the concentration of 0.01-10g/L.Peak and area of ACh-induced contraction were referred to as 100%here.For both the peak and area,fennel lg/L and lOg/L group exhibited significant difference from the NS group.While the results of fennel 0.01g/L and 0.1 g/L group were similar to NS control group.In order to investigate the action mechanism of fennel on the contraction of colon smooth muscle strip,the impacts of three antagonists,verapamil,phentolamine and atropine were obseved respectively.Peak and area of contraction induced by fennel lOg/L were referred to as 100%in this experiment.The peak and area values of verapamil+fennel group and atropine+fennel group shrank considerably compared with fennel lOg/L group.While phentolamin+fennel group showed comparable results as fennel lOg/L group.It was found that the peak value and area of contraction curve of smooth muscle strips induced by fennel lOg/L were significantly inhibited with incubation of atropine and verapamil,but there was no significant difference in phentolamine group.Conclusions1.The results suggested that fennel ironing method significantly improved gastrointestinal motility function of patients after abdominal surgery.2.Fennel showed promotive effects on spontaneous contraction of murine colon smooth muscle strips in vitro.Its possible promotive mechanism has close relations with the calcium and perhaps with the M-cholinergic receptor,but has little relation with the a-adrenergic receptor.