巩子星 刘远 张明明 宋易华

摘要 目的：探究腹腔鏡阑尾切除患者常规抗感染基础上加用黄藤通腑汤的效果。方法：选取2019年1月至2020年7月河北省中医院收治的行腹腔镜阑尾切除术患者100例作为研究对象，按照随机数字表法分为对照组和观察组，每组50例，对照组采用常规抗感染治疗，观察组采用常规抗感染+黄藤通腑汤治疗，比较2组患者血清中WBC、TNF-α、IL-6、CD3+、CD3+/CD4+、CD3+/CD8+含量差异，比较2组患者治疗前后临床康复效果、伤口愈合时间、治疗依从性及并发症状况。结果：2组患者血清中WBC、TNF-α、IL-6、CD3+、CD3+/CD4+、CD3+/CD8+的含量差异有统计学意义（P<0.05），随着时间迁移，WBC、TNF-α、IL-6、CD3+、CD3+/CD4+、CD3+/CD8+的含量呈现显著下降趋势。2组患者临床康复效果、伤口愈合时间、治疗依从性及并发症状况差异有统计学意义（P<0.05），观察组患者的临床康复效果、伤口愈合时间、治疗依从性及并发症显著好于对照组患者。结论：与常规抗感染治疗比较，腹腔镜阑尾切除术患者使用常规抗感染联合黄藤通腑汤的治疗效果更佳，值得临床推广。

关键词 腹腔镜;阑尾切除术;常规抗感染;黄藤通腑汤;炎性反应指标;免疫指标;并发症;愈合时间;依从性

Clinical Observation on the Curative Effect of Antibiotics Combined with Huangteng Tongfu Decoction after Appendectomy

GONG Zixing，LIU Yuan，ZHANG Mingming，SONG Yihua

（Hebei Provincial Hospital，Shijiazhuang 050000，China）

Abstract Objective：To explore the effect of modified Huangteng Tongfu Decoction plus conventional anti-infection in patients undergoing laparoscopic appendectomy.Methods：From January 2019 to July 2020，a total of 100 cases of laparoscopic appendectomy admitted in Hebei Provincial Hospital were selected as the research objects and were divided into a contro group and an observation group，with 50 cases in each group.The control group was treated with conventional anti-infection treatment，and the observation group was treated with conventional anti-infection+Huangteng Tongfu Decoction.The serum levels of WBC、TNF-α，IL-6，CD3+、CD3+/CD4+、CD3+/CD8+ were compared between the 2 groups.The clinical rehabilitation effect，wound healing time，treatment compliance and complications were compared between the 2 groups.Results：In the serum levels，the content of WBC、TNF-α、IL-6、CD3+、CD3+/CD4+、CD3+/CD8+ were significantly（P<0.05）.The levels of WBC、TNF-α，IL-6，CD3+、CD3+/CD4+、CD3+/CD8+ were significantly different with time migration.There were statistically significant in the clinical rehabilitation effect，wound healing time，the therapeutic compliance and complications（P<0.05）.The clinical rehabilitation effect，wound healing time，treatment compliance and complications of the observation group were significantly better than those of the control group（P<0.05）.Conclusion：Compared with conventional anti-infection therapy，laparoscopic appendectomy with routine anti-infection combined with Huangteng Tongfu Decoction is more effective and is worthy of clinical application.

Keywords Laparoscope; Appendectomy; Routine anti-infection; Huangteng Tongfu Decoction; Inflammatory markers; Immune index; Complications; Healing time; Compliance

中图分类号：R259文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.03.018

阑尾炎作为临床外科常见急腹症之一，临床表现主要为上腹痛、脐周痛、反跳痛、呕心呕吐等症状，目前，通过腹腔镜进行手术切除是治疗阑尾炎的主要方法，并且治療效果较佳，对患者机体伤害较小。但对于侵入性操作，在操作过程中极易受到微生物污染，当前大部分医院仍是采用传统的常规抗感染方法对行腹腔镜阑尾切除术患者术后创口进行感染预防，然而，随着社会的发展，人们生活观念的改变，传统的常规抗感染方法因耗时较长、抗感染效果有限等原因，已不能满足人们迫切康复的需要，近年来，常规抗感染基础上加用黄藤通腑汤的抗感染方法已逐步替代统常规抗感染方法，被广泛应用于阑尾切除术患者术后抗感染治疗，为探究这2种治疗方式的具体差异，进行了本次研究，现报道如下。……