| objective:Acute intestinal obstruction is a very common acute surgical abdominal pain, The causes of acute intestinal obstruction is various and the pathogenesis is complex. Though the diagnosis is easy, the treatment is single and the disease status changes quickly. Persistent intestinal obstruction is helpless in early enteral nutrition, contrarily, increasing the Occurrence of complicating disease to aggravate the disease, for example, the imbalance of intestinal flora, the damage of intestinal mucosal and the impaired intestinal barrier function.etc..As a result, it brings the patients a lot of pain and additional economic burden, meanwhile, prolongs the length of staying in hosipital. Our research is based on the conventional Western medicine treatment, using umbilical compressing with Chinese herbal medicine and thunder fire moxibustion on Shenque point as the treatment for acute intestinal obstruction, comparing and observing the common clinical manifestations:abdominal pain, abdominal distention, nausea and vomiting,constipation and the recovery of gastrointestinal function (anal exhaust time) to confirm the umbilical compressing with Chinese herbal medicine on acute intestinal obstruction gastrointestinal motility recovery facilitate effect of acute intestinal obstruction, analysis of common syndromes distribution, discuss the possible mechanisms of intestinal obstruction gastrointestinal function recovery through combining literature umbilical compressing with Chinese herbal medicine, standardize the acute intestinal obstruction treat and establish a foundation to traditional Chinese medicine.Method:Collecting60patients with acute intestinal obstruction from East general hospital surgery of Beijing University of Chinese Medicine between January,2010to December,2012who met the inclusion criteria, the control group with conventional western medicine treatment is random selected30patients and given the pure western medicine treatment, including fasting, gastrointestinal decompression, effective routine anti-infective, fluid infusion, maintaining water electrolyte alkali balance and so on. The treatment group with conventional western medicine treatment and Chinese herbal medicine with umbilical compressing contains the remaining30patients. On the basis of the dialection of coated tongue and pulse manifestation and corresponding syndrome, the treatment group is divided into four types:qi stagnation and blood stasis, interior heat pattern, Qi and blood deficiency pattern as well as the viscera disorder pattern.It is protocoled traditional Chinese Prescription according to the total guiding principle of traditional Chinese medicine(TCM) regulating qi and stagnation. Under the protocoled traditional Chinese Prescription, the treatment is dialectical. dampness, add with almond, immaturate Coix seed; qi deficiency, add with immaturate astragalus root, Atractylodes, radix ophiopogonis; heat pattern, add with astragalus, gardenia. grind Chinese medicinal herb into powder and modulation them into paste, daubed the paste with the self-adhesive tape and then apply tapes on Shenque point for ten minutes each time,every five minite and lasting4-6h in the aggregate. Score the Symptoms of abdominal pain, abdominal distention, the nausea and vomiting, and constipation according to visual analogue scale (VAS).Record the time of the recovery of gastrointestinal function (record anal exhaust time). Compare the morbidity of acute intestinal obstruction in different types and analysis the most common type.Results:The treatment group has collected30patients,9of them are significant effective,16of them are effective,and5cases are ineffective, so the total efficiency is83%. The control group has collected30patients with acute intestinal obstruction, six of these cases are treated significantly effective,10of them are effective, the14people of these are ineffective, the total efficiency is53.5%, there is significant difference of total efficiency between the two group (P<0.05).In the item of abdominal pain score, before treatment, there is no significance difference between the two groups (P>0.05); after therapy, abdominal pain score of the treatment group has statistical significance (P<0.05), the control group has statistical significance (P<0.05), indicate that abdominal pain of the two group significantly improved after treatment; After the treatment, there is significant difference in abdominal pain score between the two groups (P<0.05); It’s descripting that the treatment group has more significant advantages and the cerative effect is more outstanding.In the item of abdominal distension score, before treatment, there is no significance difference in abdominal distension score between the two groups (P>0.05); after therapy, abdominal distension score of the treatment group has statistical significance (P<0.05), the control group has statistical significance (P<0.05), indicate that abdominal distension of the two group significantly improved after treatment;, after the treatment, there is significant difference in abdominal distension score between the two groups (P<0.05); It indicates that the treatment group has more significant advantages and the cerative effect is more outstanding.In the item of Nausea and vomiting scores, before treatment, there is no significance difference in Nausea and vomiting scores between the two groups (P>0.05); after therapy, Nausea and vomiting scores of the treatment group has statistical significance (P<0.05), the control group has statistical significance (P<0.05) indicate that Nausea and vomiting of the two group significantly improved after treatment; after the treatment, there is significant difference in Nausea and vomiting scores between the two groups (P<0.05); It’s descripting that the treatment group has more significant advantages and the cerative effect is more outstanding.In the item of constipation score, before treatment, there is no significance difference between the two groups (P>0.05); After treatment, constipation score of the treatment group has statistical significance (P<0.05), the control group has statistical significance (P<0.05), indicate that constipation of the two group significantly improved after treatment;after the treatment, there is significant difference in constipation score between the two groups (P<0.05); It’s descripting that the treatment group has more significant advantages and the cerative effect is more outstanding.The recovery of gastrointestinal function (anal exhaust time) has statistical significance between the two group (P<0.05), prompting the Curative effect of the treatment group is better than the control group in bowel sound weakness or disappearation.Comparing the number of cases of each group between the control and treatment group, we found qi stagnation and blood stasis pattern is much more than other patterns, illustrating that the type of qi stagnation and blood stasis in acute intestinal obstruction patients of general surgery is more common.Conclusions:Through the comparation of the morbidity and index score we found that the treatment group can more effectively improve the common adverse symptoms in intestinal obstruction,such as abdominal pain, abdominal distension, Nausea and vomiting, constipation and so on.And promote enterokinesia early after operation, recover exhaust time earlier,shorter postoperative gastrointestinal recovery time. Qi stagnation and blood stasis type is more common in in patients with acute intestinal obstruction.Preliminary consideration may be associated with abdominal operation in most patients. There is wound after operation, leading to qi disorder and blood stasis. Chinese herbal medicine with umbilical compressing can effectively promote the acute intestinal obstruction gastrointestinal function’s recovery, improve and maintain the stability of the environment, promote the absorption of inflammation and the rehabilitation of the organism, reduce the chance of recurrence. Chinese herbal medicine with umbilical compressing is worthy of further clinical application and promotion with low cost, less pain, less of burden, the better curative effect and shorter time of hospitalization... |
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