摘要
目的:观察在厚朴排气合剂基础上予揿针治疗,对剖宫产术后胃肠功能恢复的增效作用与安全性。方法:将剖宫产术后产妇随机均分为对照组29例、中药组30例、针药组30例。对照组仅予术后常规处理;中药组在对照组基础上,于剖宫产术后6、10 h分别口服厚朴排气合剂50 mL;针药组在中药组基础上予揿针治疗,取穴为足三里、天枢、上巨虚、三阴交、中脘、气海及耳穴子宫、胃、大肠,产妇术后安返病房1 h内治疗,仅施治1次,连续按压3 d。记录比较3组产妇术后肠鸣音恢复时间、首次排气时间、首次排便时间、恢复半流质饮食时间,术后恶心呕吐(PONV)、腹胀发生率,术后6、24、48、72 h腹痛VAS评分,并进行安全性评价。结果:与对照组比较,中药组、针药组术后肠鸣音恢复时间、首次排气时间、恢复半流质饮食时间均明显缩短(P<0.01),针药组首次排便时间明显缩短(P<0.01);与中药组比较,针药组术后肠鸣音恢复时间、首次排气时间、首次排便时间、恢复半流质饮食时间均明显缩短(P<0.01)。与对照组比较,针药组PONV发生率降低(P<0.05),中药组和针药组腹胀发生率均降低(P<0.05,P<0.01);与中药组比较,针药组PONV及腹胀发生率均降低(P<0.05)。3组术后48、72 h腹痛VAS评分均逐渐降低(P<0.01);与对照组、中药组比较,针药组术后24、48、72 h腹痛VAS评分均明显降低(P<0.01)。整个试验过程中,均未出现与治疗相关的不良反应。结论:在厚朴排气合剂基础上加用揿针治疗对剖宫产术后胃肠功能恢复具有增效作用,且安全性高,值得临床推广应用。
Objective To observe the synergistic effect and safety of combined use of houpo paiqi mixture and thumb-tack needle on promoting gastrointestinal function recovery after cesarean section.Methods Parturients receiving cesarean section were randomly divided into the control group(29 cases),the traditional Chinese medicine(TCM)group(30 cases)and needle+TCM group(30 cases).The control group received only routine postoperative treatment.Besides the treatment as the control group,parturients in the TCM group were given 50 mL houpo paiqi mixture 6 h and 10 h after cesarean section respectively.Besides the treatment as the TCM group,parturients in the needle+TCM group received thumb-tack needle treatment at bilateral Zusanli(ST36),Tianshu(ST25),Shangjuxu(ST37)and Sanyinjiao(SP6),Zhongwan(CV12),Qihai(CV6),with auricular pressure at bilateral otopoints Zigong(Uterus),Wei(Stomach)and Dachang(Large intestine),within 1 h after the parturients returned to the ward after the operation.Each acupoint was pressed for 10 s and performed acupressure every 4 h(except sleeping hours),continuously for 3 d.The time of bowel sound recovery,the time to the first postoperative exhaust and defecation,the time of postoperative semi-fluid diet recovery,incidence of postoperative nausea and vomiting(PONV)and abdominal distention,and abdominal pain VAS score were recorded and analyzed.The safety of the treatments was also evaluated.Results Compared with the control group,the time of bowel sounds recovery,the time to the first postoperative exhaust and the time of postoperative semi-fluid diet recovery were significantly shortened in the TCM and needle+TCM groups(P<0.01);the time to the first postoperative defecation were significantly shortened(P<0.01),incidence of both abdominal distention and PONV were significantly decreased in the needle+TCM group(P<0.05,P<0.01);incidence of abdominal distention were significantly decreased in TCM group(P<0.05).Compared with the TCM group,the time of bowel sounds recovery,the time to the first postoperative exhaust and defecation,and the time of postoperative semi-fluid diet recovery were significantly shortened(P<0.01),and incidence of both abdominal distention and PONV were significantly decreased in the needle+TCM group(P<0.05).VAS scores of the three groups decreased gradually over time(P<0.01).Compared with the control and TCM groups,VAS scores of the needle+TCM group significantly decreased at 24 h,48 h and 72 h after operation(P<0.01).No treatment-related adverse reactions were observed during the whole trial.Conclusion On the base of the treatment with houpo paiqi mixture,the addition of thumb-tack needle treatment exerted positive synergistic effect on gastrointestinal function recovery after cesarean section,with high safety,which is worthy of clinical application.
作者
刘莉
崔瑾
江瑜
LIU Li;CUI Jin;JIANG Yu(School of Acupuncture-moxibustion and Tuina,Guizhou University of Traditional Chinese Medicine,Guiyang 550002,China;The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550001)
出处
《针刺研究》
CAS
CSCD
北大核心
2023年第1期83-87,101,共6页
Acupuncture Research
关键词
加速康复外科
剖宫产
术后胃肠功能障碍
揿针
Enhanced recovery after surgery
Cesarean section
Postoperative gastrointestinal dysfunction
Thumb-tack needle
