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目的:探讨奥曲肽联合四磨汤对急性粘连性肠梗阻患者肠黏膜通透性的影响及疗效观察。方法:选取72例急性粘连性肠梗阻患者,随机分为中西医组和西医组各36例。2组患者予以禁食、持续胃肠减压、抗感染、解痉止痛、维持水电解质酸碱平衡及胃肠外营养等基础治疗。中西医组予以奥曲肽联合四磨汤治疗,其中奥曲肽针0.1 mg皮下注射,每8 h治疗1次,直至肛门恢复排便排气或中转手术时停用;四磨汤口服液,每次20~40 mL,经胃肠减压管注入,夹闭1 h,直至肛门恢复排便排气或中转手术时停用。西医组予以单纯的奥曲肽治疗,用法、用量同中西医组。观察2组患者治疗前后血清内毒素(ET)和前降钙素(PCT)水平,并判断其临床疗效。结果:治疗5天后,2组血清ET和PCT水平均较前下降,差异均有统计学意义(P<0.05,P<0.01),且中西医组下降值大于西医组,差异均有统计学意义(P<0.05);同时中西医组临床总有效率高于西医组,差异有统计学意义(P<0.05)。结论:奥曲肽联合四磨汤中西医结合治疗急性粘连性肠梗阻疗效确切,能降低血清ET和PCT水平,具有良好的保护及修复肠黏膜通透性的作用。
Objective: To investigate the effect of octreotide combined with Si mill decoction on intestinal mucosal permeability in patients with acute adhesive intestinal obstruction and its therapeutic effect. Methods: Seventy-two patients with acute adhesive intestinal obstruction were randomly divided into two groups (36 cases in each group). Two groups of patients to be fasting, continuous gastrointestinal decompression, anti-infective, antispasmodic and analgesic, to maintain the basic balance of water and electrolyte acid-base balance and parenteral nutrition. Western medicine group to octreotide combined with Si mill soup, octreotide needle 0.1 mg subcutaneous injection, every 8 h treatment until anal defecation exhaust or transit surgery disabled; four mill soup oral solution, each 20 to 40 mL, the gastrointestinal decompression tube injection, clamping 1 h, until the anus to restore defecation exhaust or transit surgery disabled. Western medicine group to be a simple octreotide treatment, usage, the same amount of Chinese and Western medicine group. The levels of serum endotoxin (ET) and procalcitonin (PCT) in two groups before and after treatment were observed and their clinical efficacy was evaluated. Results: After 5 days of treatment, the levels of serum ET and PCT in the two groups were significantly lower than those in the Western medicine group (P <0.05, P <0.01), and the differences between the two groups were statistically significant (P <0.05). At the same time, the total clinical effective rate of Chinese and western medicine group was higher than that of Western medicine group (P <0.05). Conclusion: Treating acute adhesive intestinal obstruction with combination of Chinese traditional and western medicine of octreotide combined with Sihuangtang decoction can reduce the level of serum ET and PCT, and has a good function of protecting and repairing intestinal mucosal permeability.