目的探讨经皮穴位电刺激联合厚朴三物汤对膝单髁关节置换术后胃肠功能障碍患者胃肠功能恢复的影响。方法:选择2020年1月—2022年12月我院收治的94例膝单髁关节置换术后胃肠功能障碍患者，采用随机数字表法将患者均分为两组，对照组(47例)采用经皮穴位电刺激治疗，观察组(47例)采用经皮穴位电刺激联合厚朴三物汤治疗。观察两组疗效、中医症候积分、胃肠道恢复、腹痛和腹胀程度、血清胃肠激素水平和不良反应。结果:两组均无脱落病例。观察组治疗有效率高于对照组(95.74% vs 74.47%，P＜0.05)，观察组第1次肛门排气时间[(23.35±4.16) h vs (30.15±5.26] h)]，第1次排便时间[(51.32±7.23) h vs (62.35±10.77) h]，第1次肠鸣音恢复时间[(14.21±2.41)h vs (17.24±3.49) h]，开始进食时间[(74.35±10.49)h vs (80.26±13.65) h]均短于对照组(P＜0.05)。两组治疗后腹部胀满、大便不通、两胁疼痛、嗳气频频中医症候积分，腹痛和腹胀评分，血清生长抑素水平均较治疗前降低(P＜0.05)，且观察组治疗后腹部胀满，大便不通、两胁疼痛、嗳气频频中医症候积分，腹痛和腹胀评分，血清生长抑素水平低于对照组(P＜0.05)，两组治疗后血清胃动素、胃泌素均较治疗前降低(P＜0.05)，且观察组治疗后血清胃动素、胃泌素低于对照组(P＜0.05)。结论:经皮穴位电刺激联合厚朴三物汤可增强胃肠动力，促使胃肠功能恢复，缓解腹痛腹胀症状，在膝单髁关节置换术后胃肠功能障碍治疗中优于单独经皮穴位电刺激治疗。
The effect of percutaneous acupoint electrical stimulation combined with Houpu Sanwu decoction on gastrointestinal function after knee unicondylar joint replacement surgery
YANG Yi-jie,WANG Xin,FANG Qing-peng
Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou, Hebei(061000)，China
Abstract:
Objective To investigate the effect of percutaneous acupoint electrical stimulation combined with Houpu Sanwu decoction on gastrointestinal function recovery in patients with gastrointestinal dysfunction after knee unicondylar joint replacement. Methods A total of 94 patients with gastrointestinal dysfunction after knee arthroplasty were selected from the Department of our hospital from January 2020 to December 2022. The patients were divided into two groups by random number table method. The control group (47 cases) was treated with percutaneous acupoint electrical stimulation, and the observation group (47 cases) was treated with percutaneous acupoint electrical stimulation combined with Houpu Sanwu decoction. The therapeutic effect, TCM syndrome score, gastrointestinal recovery, abdominal pain and distension, serum gastrointestinal hormone level and adverse reactions were observed. Results There were no shedding cases in both groups. The effective rate in the observation group was higher than that in the control group (95.74% vs 74.47%, P <0.05). The time of first anal exhaust in the observation group was (23.35±4.16)h vs (30.15±5.26)h. First defecation time (51.32±7.23)h vs (62.35±10.77)h, first intestinal sound recovery time (14.21±2.41)h vs (17.24±3.49)h, The start time of feeding (74.35±10.49)h vs (80.26±13.65)h was shorter than that of control group (P <0.05). The TCM syndrome score of abdominal distension, constipation, pain in the two hypochondriac, belching frequent integration, scores of abdominal pain, abdominal distension and somatostatin in serum of the two groups after treatment were lower than those before treatment (P <0.05), and the TCM syndrome score of abdominal distension, constipation, pain in the two hypochondriac, belching frequent integration, scores of abdominal pain and abdominal distension in the observation group after treatment were lower than those in the control group (P <0.05), and the serum motilin and gastrin in the two groups after treatment were lower than those before treatment (P <0.05). After treatment, the serum motilin and gastrin in the observation group were lower than those in the control group (P <0.05). Conclusion Combined with Houpu Sanwu decoction can enhance gastrointestinal motility, promote the recovery of gastrointestinal function, relieve the symptoms of abdominal pain and distension, and is superior to single percutaneous acupoint electrical stimulation in the treatment of gastrointestinal dysfunction after knee unicondylar joint replacement.
