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温通法对肠结- 阳虚寒凝证疗效及肿瘤坏死因子-α 和白细胞介素-6 的影响
杨莹莹,王猛,朱鹏飞,张云杰
山东中医药大学中医医院2017 级硕士研究生 济南250000;山东中医药大学附属医院普外科济南 250014
摘要:
目的:观察温通法对肠结- 阳虚寒凝证的疗效及对肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6 的影响。方法:选取阳虚寒凝证肠梗阻患者75 例,随机分为对照组、治疗A 组、治疗B 组各25 例。对照组采用常规治疗;治疗A 组采用温通散外敷神阙穴并常规治疗;治疗B 组采用温通散外敷神阙穴并中药灌肠加常规治疗。比较3 组临床指标及TNF-α、IL-6 水平变化。结果:治疗组腹痛评分[A 组(2.80±0.70)、B组(2.16±0.74)]、腹胀评分[A 组(2.52±0.58)、B组(2.08±0.64)]、首次排气时间[A 组(3.96±0.84) 天、B 组(3.20±0.57) 天]、首次排便时间[A 组(5.20±0.70) 天、B 组(4.40±0.73) 天]、肠鸣音恢复时间[A 组(2.12±0.60) 天、B 组(1.76±0.66) 天] 较对照组腹痛(3.32±0.94)、腹胀(2.96±0.84)、首次排气时间(4.92±0.90) 天、首次排便时间(6.04±0.97) 天、肠鸣音恢复时间(2.64±0.63) 天, 均有所改善(P < 0.05)。治疗组中医证候疗效(A 组80%、B 组92%)及临床症状疗效(A 组80%、B 组92%)较对照组中医证候疗效(64%)及临床症状疗效(60%)均有所提高(P < 0.05)。治疗组TNF-α 水平[A 组(41.62±1.55) pg/mL、B 组(31.51±1.40) pg/mL]、 IL-6[A 组(45.93±3.18) ng/mL、B 组(31.54±2.49) ng/mL] 均低于对照组TNF-α(54.41±1.35)pg/mL、IL-6(71.89±2.94)ng/mL,且治疗B 组在临床指标、实验室指标、中医证候疗效及临床症状疗效方面较治疗A 组均有所改善(P < 0.05)。结论:温通法治疗阳虚寒凝证肠梗阻疗效确切,能够改善患者临床症状、促进胃肠功能的恢复,并降低TNF-α、IL-6 水平。
关键词:  温通法  肠梗阻  阳虚寒凝证  白细胞介素6  肿瘤坏死因子-α
DOI:10.3969/j.issn.1007-6948.2020.04.012
投稿时间:2019-12-06
基金项目:山东省重点研发计划(2018GSF119026);山东省中医药科技发展计划项目(2019-0179);山东省中医药科技发展计划项目(2019-0103)
Effect of Wentong Method on the Curative Effect of Intestinal Node-Yang Deficiency and Cold Coagulation and the Effects of TNF-α and Interleukin- 6
YANG Ying-ying,WANG Meng,ZHU Peng-fei
Abstract:
Objective To observe the effect of Wentong method on the efficacy of intestinal node-yang deficiency and cold coagulation syndrome and the effects of TNF-αandinterleukin-6. Methods Seventyfivepatients with intestinal node-yang deficiency and cold coagulation syndrome were selected and divided into control group, treatment group A and treatment group B, which 25 cases in each group. Control group:conventional treatment; treatment group A: Wentongsan external applicationShenqueacupoint + conventional treatment; treatment group B: Wentongsan external applicationShenqueacupoint + traditional Chinese medicine enema + conventional treatment. Compare the clinical indicators and changes of TNF-α and interleukin-6 levels in the above threegroups. Results Abdominal pain( groupA: 2.80±0.70, group B: 2.16±0.74), abdominal distension ( groupA: 2.52±0.58, group B: 2.08±0.64), first exhausttime ( groupA: 3.96±0.84, groupB :3 . 20 ± 0 . 57 ),first defecation time ( groupA:5 . 20± 0 . 70 , group B: 4 . 40 ± 0 . 73 ), recovery time of bowel sounds ( groupA: 2 . 12 ± 0 . 60 ,group B: 1.76±0.66). The treatment group were improved than those in the control group(P <0.05) :abdominal pain (3.32±0.94), abdominal distension(2.96±0.84), first exhaust time (4.92±0.90), firstdefecationtime(6.04±0.97), recovery time of bowel sounds (2.64±0.63). The TCM syndrome ( groupA: 80%, group B: 92%) and clinical ef?cacy (groupA : 80%, group B: 92%). The treatment group were improved than those in the control group(P<0.05): TCM syndrome (64%) and clinicalsymptomsef?cacy (60%). The TNF-α [( groupA: (41.62±1.55) pg/mL, group B: (31.51±1.40) pg/mL], interleukin -6 [( groupA: (45.93±3.18) pg/mL, group B: (31.54±2.49) ng/mL] in the treatment group was lower than those in the control: TNF-α [(54.41±1.35) pg/mL], interleukin-6[(71.89±2.94) ng/mL]. The clinical parameters, laboratory parameters, TCM syndrome and clinical effect in group B was higher than those in group A(P<0.05). Conclusion Wentong method is effective in treating intestinal node-yang de?ciency and cold coagulation.It canimprove clinical symptoms, promote the recovery of gastrointestinal function and reduce the levels of TNF-α and interleukin-6.
Key words:  Wentong method  intestinal obstruction  yang deficiency and cold coagulation syndrome  

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