| With the rapid development of surgical technology and the continuous innovation of abdominal surgery technology.At present,abdominal surgery can treat many kinds of abdominal diseases and has good prognosis.Meanwhile,the incidence of complications after abdominal surgery was also significantly reduced.However,the incidence of gastrointestinal function is still high.In pathophysiology,the pathological changes of gastrointestinal dysfunction can be summarized into three aspects:first,the gastrointestinal barrier is damaged,followed by gastrointestinal microecological disorder,and finally refers to the motility disorder of the stomach and intestine.According to the research results,these three aspects are not independent,but can interact and transform each other.Any problem will eventually lead to gastrointestinal dysfunction complications.Therefore,how to effectively avoid the occurrence of adverse reactions of gastrointestinal disorders is one of the problems to be solved in clinical practice.Modern medicine and traditional Chinese medicine try to recover gastrointestinal function as soon as possible through various treatment methods,and further avoid the adverse events of gastrointestinal dysfunction.At present,in the field of modern medical research,the treatment of gastrointestinal dysfunction has not formed a unified standard,so the clinical effect is not good.In recent years,many researchers have tried to use traditional Chinese medicine to prevent and treat gastrointestinal dysfunction after gastrointestinal surgery,and often achieve good results.Among them,the traditional Chinese medicine enema treatment drugs absorbed through the rectal mucosal venous plexus,directly act on the gastrointestinal tract,reduce the first pass effect of the liver,can improve the local drug bioavailability,play a fast role.The main functions of traditional Chinese medicine and rhubarb are to promote intestinal peristalsis,improve gastrointestinal motility and local blood circulation,and also have the function of bacteriostasis and reduce intestinal adhesion.In modern medical research,rhubarb is mainly anthraquinone derivatives,which contains rhein,chrysophanol,emodin,aloe emodin and emodin ether and other free elements.The results showed that the above effective free components of rhubarb can effectively promote the recovery of intestinal peristalsis,and promote the excretion of intestinal bacteria and toxins,and further stabilize the intestinal microecological system.The above effects of rhubarb can balance intestinal flora effectively.At the same time,there are still studies that rhubarb has a bidirectional regulation effect on the immune system of the body.Rhubarb can effectively remove the oxygen free radicals in the intestine,reduce the permeability of intestinal capillary,further prevent endotoxin from entering the blood,and effectively avoid the occurrence of endotoxemia.Whether rhubarb can effectively promote the recovery of gastrointestinal function after abdominal surgery has not been effectively verified.,Objective:This study aims to summarize the operation methods,drug selection and disease types of traditional Chinese medicine enema,so as to guide the specific process of enema in clinical work.Meanwhile,the recovery of gastrointestinal function of patients after laparoscopic surgery was evaluated by meta-analysis.The application effect of enema technology in laparoscopic surgery was further clarified.Finally,the clinical randomized control study was designed to further clarify the effect of rhubarb enema on abdominal surgery.Methods:search the related literature of enema through key words in each database,read the literature and summarize it,and clarify the specific operation and application process of Chinese medicine enema in digestive system diseases.Through the keywords "traditional Chinese medicine","enema","clysma","clinical".Chinese key words:"Chinese medicine","enema","surgery" search the documents in each database,and select the appropriate documents by inclusion and exclusion criteria and then bring them into meta-analysis.The basic data of each document were extracted.The main outcome indicators were:the recovery time of the bowel sounds,the first exhaust time and the first defecation time.The secondary outcome-measures were:postoperative abdominal distention,the incidence of incision infection complications,and hospitalization time.The relevant data analysis is carried out by using Review Manager 5.3 software.The effect of enema on gastrointestinal function after abdominal operation was clarified.The patients were randomly divided by the criteria of inclusion and exclusion through the design of randomized controlled study.The experimental group was treated with rhubarb enema.The recovery time,first exhaust time and first defecation time were recorded.The abdominal pain,abdominal distention and gastrointestinal function were recorded on the first day and fifth day after operation.Results:The results of meta-analysis showed that Chinese medicine enema can effectively shorten the recovery time of bowel sounds,the first defecation time and the first exhaust time of patients after digestive system surgery,whether they underwent laparotomy or laparoscopic surgery.Reduce postoperative abdominal distension and incision infection complications.The length of hospital stay was significantly shortened.The results of clinical randomized controlled trials showed that rhubarb enema can significantly shorten the recovery time of bowel sounds,the first defecation time and the time of gastric tube removal in patients with abdominal surgery.The first exhaust time was shorter than that of the control group,but the difference was not statistically significant.In addition,rhubarb enema alleviated the degree of abdominal distension on the first day and the fifth day after operation,and significantly reduced the gastrointestinal reaction on the fifth day after operation.Compared with the control group,the incidence of incision infection and postoperative intestinal obstruction was also significantly reduced.Although there was no significant difference in the length of stay between the two groups,the quality of life score of the experimental group was better than that of the control group before discharge.However,there was no significant effect of rhubarb enema on the degree of abdominal pain on the first and fifth day after operation.Conclusion:① Traditional Chinese medicine enema is widely used in the treatment of digestive system diseases,which has definite curative effect,but the operation is lack of uniform standard.②Meta analysis showed that traditional Chinese medicine enema in the surgical treatment of digestive system diseases,whether open surgery or laparoscopic surgery,the application of traditional Chinese medicine enema in the perioperative period can effectively promote the recovery of postoperative gastrointestinal movement and gastrointestinal function,but also can effectively avoid postoperative complications such as abdominal distension,incision infection and other complications,shorten the hospitalization time of patients.Chinese medicine enema drug selection can be reasonable use of rhubarb,Magnolia officinalis,Aucklandia,Fructus aurantii and other traditional Chinese medicine monomer components.③ Clinical studies have confirmed that rhubarb preparation enema can effectively promote the recovery of gastrointestinal function after abdominal surgery,accelerate the recovery of bowel sounds,shorten the first defecation and gastric tube indwelling time,relieve abdominal distension,gastrointestinal reaction and other discomfort,and reduce the occurrence of postoperative complications.Conclusion:Rhubarb enema can effectively promote the recovery of gastrointestinal function after abdominal surgery.Significance:whether patients can recover gastrointestinal function smoothly or even quickly after operation determines the quality and even success of an abdominal surgery.More and more scholars turn to traditional Chinese medicine for solutions,and traditional Chinese medicine accelerated rehabilitation surgery emerges as the times require,Our study confirmed that the reasonable application of traditional Chinese medicine enema,especially rhubarb preparation enema in the perioperative period of abdominal surgery can significantly promote the recovery of gastrointestinal function,accelerate the recovery of patients,and has obvious application effect on the treatment and prognosis of the disease. |
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