Abstract:

Objective　To investigate the effect of Simo decoction on gastrointestinal hormone level in patients with cholelithiasis after operation. Methods　A total of 102 patients with cholelithiasis admitted to Lianyungang Traditional Chinese Medicine Hospital from January 2019 to January 2022 were selected for this study, who all underwent laparoscopic cholecystectomy (LC). After operation, the patients were divided into an observation group and a control group according to the random number table method, with 51 cases in each group. In the observation group, there were 20 males and 31 females; the patients were aged 22-64 years, with an age of (43.17±3.74) years old; they were treated with conventional anti-infection and liver protection therapy plus Simo decoction. In the control group, there were 21 males and 30 females; the patients were aged 21-63 years, with an age of (42.62±3.49) years old; they were given routine anti-infection and liver protection treatment. The treatment effects of the two groups were compared, and the traditional Chinese medicine (TCM) symptom scores of abdominal distension, loss of appetite, pulse string, chest tightness and nausea, frequent belching, and red tongue and white fur were compared between the two groups before and after treatment. The anal exhaust time, bowel call relief time, defecation time, and feeding time of the two groups were compared. The levels of gastrin (GAS), motilin (MTL), and somatostatin (SS) before and after treatment were compared between the two groups, and the adverse reactions were compared between the two groups. Independent sample t test and paired t test were used for the measurement data, and χ² test was used for the count data. Results　The total effective rate of the observation group was significantly higher than that of the control group [92.16% (47/51) vs. 70.59% (36/51)], with a statistically significant difference (χ²=7.826, P=0.005). After treatment, the TCM symptom scores of abdominal distension, loss of appetite, pulse string, chest tightness and nausea, frequent belching, and red tongue and white fur in the observation group were lower than those in the control group (all P<0.05). Compared with those in the control group, the duration of anal exhaust [(33.56±5.44) h], bowel sound relief time [(18.76±3.28) h], defecation time [(40.56±6.67) h], and feeding time [(37.27±6.24) h] were shorter in the observation group (all P<0.05). After treatment, the level of GAS [(112.87±18.25) ng/L] and MTL [(203.81±22.13) ng/L] in the observation group were lower than those in the control group, and the level of SS [(48.96±8.09) ng/L] was higher than that in the control group (all P<0.05). The total incidence of adverse reactions in the observation group was lower than that in the control group [3.92% (2/51) vs. 17.64% (9/51)], with a statistically significant difference (χ²=4.993, P=0.025). Conclusion　Simo decoction can effectively relieve the clinical symptoms in cholelithiasis patients after operation, shorten the recovery time of various indexes of gastrointestinal function, regulate the gastrointestinal hormone level, and have high safety and less adverse reactions.

Key words:

Cholelithiasis, Laparoscopic cholecystectomy, Simo decoction, Gastrointestinal hormones, Gastrointestinal function

摘要：

目的　探讨四磨汤用于胆石症患者术后对胃肠激素水平的影响。方法　选取连云港市中医院在2019年1月至2022年1月收治的102例胆石症患者进行研究，患者均进行腹腔镜胆囊切除术（LC），术后按照随机数字表法将患者分为观察组和对照组，每组51例。观察组男性20例，女性31例；年龄22～64（43.17±3.74）岁；给予常规抗感染、保肝治疗、四磨汤治疗。对照组男性21例，女性30例；年龄21～63（42.62±3.49）岁；给予常规抗感染、保肝治疗。比较两组患者的治疗效果，比较两组患者治疗前后腹部胀痛、食欲不振、脉弦、胸闷恶心、嗳气频作、舌红苔白的中医症状积分，比较两组患者肛门排气时间、肠鸣音缓解时间、排便时间和进食时间，比较两组患者治疗前后的胃泌素（GAS）、胃动素（MTL）和生长抑素（SS）水平，比较两组患者的不良反应情况。采用独立样本t检验、配对t检验和χ²检验。结果　观察组总有效率92.16%（47/51）高于对照组70.59%（36/51），差异有统计学意义（χ²=7.826，P=0.005）。治疗后，观察组腹部胀痛、食欲不振、脉弦、胸闷恶心、嗳气频作、舌红苔白的中医症状积分均比对照组低（均P<0.05）。与对照组比较，观察组患者的肛门排气（33.56±5.44）h、肠鸣音缓解（18.76±3.28）h、排便（40.56±6.67）h以及进食时间（37.27±6.24）h更短（均P<0.05）。治疗后，观察组GAS（112.87±18.25）ng/L、MTL水平（203.81±22.13）ng/L均比对照组低，SS水平（48.96±8.09）ng/L比对照组高（均P<0.05）。观察组不良反应总发生率3.92%（2/51）低于对照组不良反应总发生率17.64%（9/51），差异有统计学意义（χ²=4.993，P=0.025）。结论　四磨汤可以有效缓解胆石症患者术后的临床症状，缩短胃肠功能各指标的恢复时间，调节胃肠激素水平且安全性高、不良反应少。

关键词:

胆石症, 腹腔镜胆囊切除术, 四磨汤, 胃肠激素, 胃肠功能