柴芍承气汤内服联合隔物灸神阙穴对腹腔镜胆囊切除术后胃肠功能恢复的临床疗效OA
Clinical efficacy of Chaishao Chengqi decoction oral administration combined with indirect moxibustion at Shenque acupoint on gastrointestinal function recovery after laparoscopic cholecystectomy
目的:探讨柴芍承气汤内服联合隔物灸神阙穴对腹腔镜胆囊切除术后患者胃肠功能恢复的临床疗效,并分析其可能的作用机制.方法:选取2022年6月-2025年6月于我院行腹腔镜胆囊切除术的120例患者,按随机数字表法随机分为对照组与观察组,每组各60例.对照组予以常规治疗,观察组在此基础上加用柴芍承气汤内服联合隔物灸神阙穴治疗,观察并比较两组患者胃肠功能恢复指标、疼痛视觉模拟评分(VAS评分)及进食恶心-呕吐-查体-症状持续时间评分系统(I-FEED)评分、中医证候积分、胃肠激素水平及炎性因子水平,并比较两组临床疗效.结果:观察组首次排气时间、首次排便时间及肠鸣音恢复时间均短于对照组(P<0.05);术后第5天,观察组VAS评分和I-FEED评分均显著低于对照组(P<0.05);术后48 h及术后第5天,观察组中医证候积分显著低于对照组(P<0.05),且时间主效应、组间主效应及交互效应均具有统计学意义(均P<0.001);术后第5天,观察组血清胃动素(MTL)及胃泌素(GAS)水平高于对照组,血管活性肠肽(VIP)水平低于对照组(P<0.05);术后第5天,观察组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平显著低于对照组(P<0.05);观察组总有效率(93.33%)显著高于对照组(75.00%),差异有统计学意义(P<0.05).结论:柴芍承气汤内服联合隔物灸神阙穴可有效促进腹腔镜胆囊切除术后患者胃肠功能恢复,减轻疼痛及胃肠功能障碍程度,改善中医证候积分,调节胃肠激素水平及炎性因子水平,临床疗效显著.
Objective To explore the clinical efficacy of oral administration of Chaishao Chengqi decoction combined with indirect moxibustion at Shenque acupoint in promoting gastrointestinal function recovery in patients after laparoscopic cholecystectomy,and to analyze its potential mechanism of action.Methods 120 patients undergoing laparoscopic cholecystectomy at our institution between June 2022 and June 2025 was prospectively enrolled.Participants were randomized into two groups:a control group(n=60)receiving standard postoperative care,and an observation group(n=60)receiving adjunctive therapy comprising oral Chaishao Chengqi decoction combined with indirect moxibustion at the CV8(Shenque)acupoint.Comparative analysis encompassed gastrointestinal functional recovery indices,visual analogue scale(VAS)and I-FEED scores,Traditional Chinese Medicine(TCM)syndrome scores,gastrointestinal hormone profiles,inflammatory cytokine levels,and overall clinical efficacy.Results The observation group demonstrated significantly accelerated resumption of gastrointestinal function versus controls,evidenced by shorter time to first flatus,first defecation,and bowel sound resumption(P<0.05).At postoperative day 5,the observation group exhibited markedly reduced VAS and I-FEED scores compared to the control group(P<0.05).TCM syndrome scores were significantly lower in the observation group at both 48 hours and 5 days postoperatively(P<0.05).Repeated-measures ANOVA confirmed statistically significant main effects for time and group allocation,alongside a significant time-group interaction(all P<0.001).By day 5,serum motilin(MTL)and gastrin(GAS)levels were substantially elevated in the observation group,while vasoactive intestinal peptide(VIP)levels were significantly suppressed relative to controls(P<0.05).Serum concentrations of tumor necrosis factor-alpha(TNF-α)and interleukin-6(IL-6)were significantly attenuated in the observation group compared to the control group at postoperative day 5(P<0.05).The observation group achieved a significantly higher overall response rate(93.33%vs 75.00%,P<0.05).Conclusion Oral administration of Chaishao Chengqi decoction combined with indirect moxibustion at Shenque acupoint can effectively promote gastrointestinal function recovery in patients after laparoscopic cholecystectomy,alleviate pain and gastrointestinal dysfunction,improve TCM syndromes,regulate gastrointestinal hormone levels,and reduce inflammatory factor levels,with remarkable clinical efficacy.
严格非;叶喃喃;练志明
广州中医药大学附属广州中西医结合医院(广州 510800)广州中医药大学附属广州中西医结合医院(广州 510800)广州中医药大学附属广州中西医结合医院(广州 510800)
医药卫生
柴芍承气汤隔物灸神阙穴腹腔镜胆囊切除术胃肠功能随机对照试验胃肠激素炎性因子
Chaishao Chengqi decoctionindirect moxibustionShenque acupointlaparoscopic cholecystectomygastrointestinal functionrandomized controlled trialgastrointestinal hormonesinflammatory factors
《中国中西医结合外科杂志》 2026 (3)
324-329,6
广东省广州中医药大学人文社科扶持专项(2021SKZX08)
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