加味硝黄贴辅助治疗胸腰椎骨折后麻痹性肠梗阻的临床观察
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篇名: 加味硝黄贴辅助治疗胸腰椎骨折后麻痹性肠梗阻的临床观察
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摘要: 目的:观察加味硝黄贴辅助治疗胸腰椎骨折后麻痹性肠梗阻的临床疗效及安全性。方法:将138例胸腰椎骨折后麻痹性肠梗阻的患者按随机数字表法分为对照组(A组)43例、硝黄贴组(B组)47例和加味硝黄贴组(C组)48例。A组患者采用禁食、胃肠减压、补液及营养支持等基础治疗;B组患者在A组基础上加用硝黄贴;C组患者在A组基础上加用加味硝黄贴。B、C组贴剂均每12 h更换1次,至患者肠蠕动恢复、肛门排气为止,但疗程最多为5 d。比较3组患者临床症状改善时间、治疗前后的视觉模拟评分法(VAS)评分和C反应蛋白(CRP)水平,以及不良反应发生情况。结果:治疗后,在胃肠减压时间、肠鸣音恢复时间和肛门排气时间方面,B、C组明显短于A组,C组明显短于B组,差异均有统计学意义(P<0.05)。治疗前,3组患者的VAS评分和CRP水平比较,差异均无统计学意义(P>0.05);治疗后,3组患者的腹胀、腹痛VAS评分和CRP水平均较治疗前明显降低,且C组患者的腹胀、腹痛VAS评分和CRP水平均明显低于A、B组,B组患者的CRP水平明显低于A组,差异均有统计学意义(P<0.05);但A、B组患者的VAS评分比较,差异无统计学意义(P>0.05)。3组患者均未见明显不良反应发生。结论:加味硝黄贴辅助治疗胸腰椎骨折后麻痹性肠梗阻,可明显缩短治疗时间,减轻患者腹胀、腹痛症状,减轻炎症,且安全性较高。
ABSTRACT: OBJECTIVE: To observe clinical efficacy and safety of Modified xiaohuang paste in the treatment of paralytic ileus after thoracolumbar fractures. METHODS: One hundred and thirty-eight patients with paralytic ileus after thoracolumbar fractures were divided into control group (group A, 43 cases), Xiaohuang paste group (group B, 47 cases) and Modified xiaohuang paste group (group C, 48 cases). Group A was given routine treatment as fasting, gastrointestinal decompression, fluid replacement, nutritional support; group B was additionally given Xiaohuang paste on the basis of group A; group C was additionally given Modified xiaohuang paste on the basis of group A. Group B and C were given relevant paste every 12 h until intestinal peristalsis was recovered and gas exhausted from anus, at the most for 5 days. The improvement time of clinical symptom improvement, VAS score and CRP level were compared among 3 groups as well as the occurrence of ADR. RESULTS: After treatment, the time of gastrointestinal decompression, bowel sound recovery and passage of gas by anus in group B and C were significantly shorter than group A, and group C was significantly shorter than group B, with statistical significance (P<0.05). Before treatment, there was no statistical significance in VAS score and CRP level among 3 groups (P>0.05). After treatment, VAS score of abdominal pain and distension, CRP level of 3 groups were decreased significantly compared to before treatment; those of group C were significantly lower than group A and B, and CRP level of group B was significantly lower than that of group A, with statistical significance (P<0.05). There was no statistical significance in VAS score between group A and B (P>0.05). No significant ADR was found in 3 groups. CONCLUSIONS: For paralytic ileus after thoracolumbar fracture, Modified xiaohuang paste can significantly shorten treatment duration, relieve abdominal distension and pain, inflammation with good safety.
期刊: 2017年第28卷第8期
作者: 罗亚丽,李辉映,王耀华,俞平,钱军
AUTHORS: LUO Yali,LI Huiying,WANG Yaohua,YU Ping,QIAN Jun
关键字: 加味硝黄贴;胸腰椎骨折;麻痹性肠梗阻
KEYWORDS: Modified xiaohuang paste; Thoracolumbar fracture; Paralytic ileus
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