Research On Safety Of Promoting The Recovery Of Gastrointestinal Motility At Earlier Period Of Colonic Anastomosis Using Xiaochengqi Mixture

ObjectiveThere is substantial support in the literature for the idea that disorderof GI (Gastrointestinal) motility exist universally in patients undergoingall kinds of abdominal surgery. GI motility restrained for a long time maybring on a series of side effect, consequently it is a significant cause ofdelayed recovery from surgery. It is believed that earlier recovery of GImotility should influence the safety of anastomotic stoma, for this reason,these means general principles of postoperative care (e.g., use of tubes,fasting) are recommended until recovery of GI motility naturally. Accordingto latest reseach, early resumption of an oral diet is essential for self-carein accordance with natural demand of physiology; early resumption of enteralfeeding may avoid a series of side effect facilitated by the methods of fastingand total parenteral nutrition, furthermore, early resumption of enteralfeeding is safe, without increasing the risk of serious complications such asanastomotic leakage, celiac infection. This research integrates clinicalresearch and animal experiment, research on patients or rats with colonicanastomosis, the objects were received Xiaochengqi mixture(add Danshen toXiaochengqi decoction)at earlier period of colonic anastomosis, to observe theeffect and safety of recovery of gastrointestinal motility at earlier period.MethodsThis study is composed of animalexperiment and clinical research. (1)Part of experimental animal: wistar rats with model of colonic anastomosiswere randomly divided into the treatment group(groupâ… ) and the controlgroup(groupâ…¡),rats of groupâ… were received xiaocheng qi mixture by nasal feeding just 5 hours after surgery, compared with rats of groupâ…¡who werereceived the same dosage of clear water in the same way. We continued to dothat twice a day in the morning of the second day and the third day. To observethe survival of rats in each group. In case of animal was dead during theexperiment, we performed exploratory laparotomy immediately to find out thecause of death. All the rats were received exploratory laparotomy at thethird, Tth, 14th days after operation, we tookiO rats from each group everytime to carry through acute load-test, then we observed the condition ofanastomotic concrescence, moreover index of celiac conglutination wasgraded. Using the statistical software to obtain the result through comparingdatas. (2)Part of clinical research:according to inclusion criteria, patientswith colonic anastomosis were randomly divided into the treatment group(groupâ… ) and the control group(groupâ…¡).Besides the general management, patientsof groupâ… were received xiaochengqi mixture by nasal feeding just 3 hours aftersurgery, We continued to do that twice one day until patients who had the fistdefecation. In groupâ…¡,patients were accepted fasting until fist exhaust intraditional way. To observe endurance of these patients and complication suchas anastomotic leakage during hospitalization. Record the time of borborygmus,fist exhaust and defecation. Using the statistical software to obtain theresult through comparing datas.Results(1) part of animal experiment:There were three animals dead in all, oneof them died in groupâ… at the day of surgery, the reason may be excessiveanaesthetic. There was one dead of primary intestinal leakage and celiacinfection at the second day after surgery in the groupâ…¡, another was deadof ileus at the third day, the others were survival. Compared with groupâ…¡,thegrades of anastomotic conglutination were less in groupâ… .Anastomotic stomaof two groups went up to certain hydraulic pressure, and none of them appearedanastomotic dehiscence. (2) part of clinical research: all the patients couldbe able to endure xiaochengqi mixture by nasal feeding and completed theexperiment. There was one patient with ileus in groupIIand curable throughconservative treatment. Patients in groupâ… were distinctly better than groupâ…¡such as the time of borborygmus, fist exhaust and defecation.Conclusions1. It is safe to receive xiaochengqi mixture by nasal feeding at earlier period of colonic anastomosis. Most of patients can endure, furthermore,without increasing the risk of anastomotic leakage, celiac infection anddeath.2. Xiaochengqi mixture can effectively promote the recovery ofgastrointestinal motility at earlier period of colonic anastomosis. The timeof borborygmus, fist exhaust and defecation can be obviously ahead.3. Xiaochengqi mixture can alleviate the degree of intestinal adhesionsat earlier period of colonic anastomosis effectively.