| Objective:To observe the clinical effect and curative effect of Changshu Tang on diversion colitis,patients of terminal ileostomy were treated with Changshu Tang retention enema.Methods:Sixty patients were divided into 2 groups with 30 patients in each group by random number table method.Observation group was given reservation enema of Changshu Tang before surgery for 2 weeks,once a day.Composition of Changshu Decoction: Zhihuangqi 15 g,Magnolia officinalis 9 g,Wuyao 9 g,Jiao hawthorn 12 g,Glycyrrhiza 6 g,Muxiang 9 g,Guizhi 9 g,Fried Zhishi 12 g,Chaihu 9 g,Rhubarb 6 g,Sanling 9 g,Fried Atractylodes 12 g,and Ezhu 9 g.The decocting was uniformly made in the decocting room,and the decocted Chinese medicine was about 200 ml,the temperature was kept at about 40 degrees,and anterograde enema was performed through terminal ileostomy intubation.Patients take the hypothesis,remove the pocket,the intestinal Shu Shang enema bag hanging from patients about 50 cm high,paraffin oil lubrication 16 F double cavity after balloon catheter,the terminal ileum colostomy inserted far period of ileum about 10 ～ 15 cm,air injection of saline 10 ml,to gently pull resistance can begin feeling slightly enema,speed per minute 50～ 60 drops.After the enema was finished,the air bag was emptied,the catheter was pulled out,and the pocket was fixed again and left for 1 hour.The patient was asked to alternate left side decubitus,right side decubitus and supine position,and was discharged after 1 hour.The control group was treated by enema with normal saline at 40℃.All the 60 patients underwent electronic colonoscopy 4 months after terminal ileostomy,before and 2 weeks after enema.There is no need to clean and enema the diversion colon before examination.The patient was placed in the left decubus position and entered through the anus to observe the presence of erythema and swelling,inflammatory follicular hyperplasia,erosion ulcer and inflammatory polyp in the diversion colon mucosa.Meanwhile,intestinal mucosa tissues were taken for pathological examination.In addition,the changes of the time of exhaust and defecation,feeding time,analgesic effect and inflammatory markers after ileal restoration were discussed.To observe the change of modified Mayo score and evaluate the clinical effect of Changshu Tang retention enema..Results:Before treatment,there was no significant difference between the two groups in colonic erythema swelling,erosion ulcer,inflammatory follicular hyperplasia and inflammatory polyp(P > 0.05).After treatment,erythema swelling and inflammatory follicular hyperplasia in observation group were significantly decreased compared with before treatment and control group(P < 0.05).After treatment,there was no significant difference in erosive ulcer and inflammatory polyp between the observation group and the control group(P > 0.05),but the ulcer of the observation group had a certain trend of improvement.The effective rate was26.67% in the control group and 70.00% in the observation group.For inflammatory follicular hyperplasia,the effective rate was 20.00% in the control group and 47.82% in the observation group.For ulcer erosion,the effective rate was 5.56% in the control group and45.00% in the observation group.After retention enema treatment with Changshu Tang,the inflammatory manifestations of diversion colon were significantly improved,the histopathological characteristics of colon mucosa were significantly improved,the modified Mayo score was significantly improved,and the pain score showed a decreasing trend.The time of eating,the time of anal defecation and the hospital stay in the observation group were significantly shortened.Conclusions:Changshu Tang retention enema in the treatment of the diversion colon can promote the repair of intestinal mucosa injury and the healing of ulcer tissue,promote the recovery of intestinal function of patients after terminal ileostomy closure,and improve the quality of life of patients,which is worthy of clinical promotion and application. |
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