纪世敏+李万胜+赵斌

[摘要] 目的 研究降逆理氣汤在治疗消化系统恶性肿瘤术后胃瘫综合征的疗效。方法 方便选取2014年1月—2015年12月住院的110例消化系统恶性肿瘤术后胃瘫综合征的患者作为该次研究对象，随机分为治疗组60例和对照组50例， 治疗组用在常规西医治疗的基础上加用降逆理气汤中药方剂治疗。对照组常规西医治疗加莫沙必利5 mg口服和胃复安10 mg静脉点滴。比较两组治疗前、治疗后3、7 d血清中胃动素、IL-6水平；治疗后饮食恢复正常的时间。结果 治疗组治疗前胃动素水平（256.2±15.2）mg/mL与对照组（262.9±11.5）mg/mL比较差异无统计学意义（P>0.05）；治疗组治疗后第3天（352.1±19.2）mg/mL、第7天胃动素水平（485.4±18.1）mg/mL明显高于对照组（293.2±14.1）、（371.6±13.2），差异有统计学意义（P<0.05）；治疗组治疗前IL-6水平（23.2±3.2）pg/mL与对照组（24.3±5.2）pg/mL比较差异无统计学意义（P>0.05）；治疗组治疗后第3天（19.4±2.1）pg/mL、第7天IL-6水平（13.2±4.2）pg/mL显著低于对照组（22.4±6.2）pg/mL、（19.4±7.1）pg/mL，差异有统计学意义（P<0.05）；两组治疗后饮食恢复正常的时间比较：治疗组饮食恢复正常时间（11.2±1.3）d明显短于对照组（18.5±2.6）d，两组差异有统计学意义（P<0.05）。结论 降逆理气汤对治疗消化系统恶性肿瘤术后胃瘫综合征有良好的疗效，能够促进胃瘫综合征患者快速康。

[关键词]

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2017）04（c）-0175-03

[Abstract] Objective To research the curative effect of gastroparesis syndrome after Jiangni Liqi decoction in treatment of digestive system malignant tumors. Methods 100 cases of patients with gastroparesis syndrome after the digestive system malignant tumors treated in our hospital from January 2014 to December 2015 were selected and randomly divided into two groups， the treatment group with 60 groups adopted the Jiangni Liqi decoction on the basis of the routine western medicine， while the control group adopted the routine western medicine and oral administration of 5mg mosapride and intravenous injection of 10mg metoclopramide， and the metoclopramide in serum and IL-6 levels before treatment and at 3、7 d after treatment and the time of dieting returning to normal were compared between the two groups. Results The difference in the metoclopramide level before treatment between the treatment group and the control group was not statistically significant， [（256.2±15.2）mg/mL vs （262.9±11.5）mg/mL]（P>0.05）， and the metoclopramide levels at 3、7 d after treatment in the treatment group were obviously higher than those in the control group[（352.1±19.2），（485.4±18.1）mg/mL vs （293.2±14.1），（371.6±13.2）mg/mL]， and the differences were statistically significant（P<0.05）， and the difference in the IL-6 level before treatment between the treatment group and the control group was not statistically significant[（23.2±3.2）pg/mL vs （24.3±5.2）pg/mL]（P>0.05）， and the IL-6 levels at 3、7 d after treatment were obviously lower than those in the control group [（19.4±2.1）， （13.2±4.2）pg/mL vs （22.4±6.2），（19.4±7.1）pg/mL]， and the differences were statistically significant（P<0.05）， after treatment， the time to return to normal of dieting was obviously shorter than that in the control group[（11.2±1.3）d vs （18.5±2.6）d]， and the difference between groups was statistically significant（P<0.05）. Conclusion The curative effect of Jiangni Liqi decoction in treatment of digestive system malignant tumors is good， which can promote the rapid recovery of gastroparesis syndrome.

[Key words] Jiangni Liqi decoction； Postoperative gastroparesis syndrome； Serum albumin； Time to return to normal of dietin

在临床手术中胃部手术较为常见，但是手术操作容易使患者的神经激素进行改变，同时还会改变其肌源性因素，在一定程度上会引发胃毯综合征，其主要临床症状以腹部疼痛、呕吐以及恶心为主。从目前的临床报道来看，该疾病的引发机制不是十分明确，且以往的治疗方法首选胃肠减压、肠内外营养支持，但是难以达到理想的治疗效果。近年来，该疾病住进引入中医治疗，从中医角度来看，该疾病与脾胃虚弱和气机逆乱存在相关性。鉴于此，该研究分析降逆理气汤在治疗消化系统恶性肿瘤术后胃瘫综合征的疗效，方便抽取2014年1月—2015年12月住院的110例消化系统恶性肿瘤术后胃瘫综合征的患者作为该次研究对象，现报道如下。