Preventive Effect Of The Jolt Therapy Joint Tongfu Xiaoyin Decoction On The Early Postoperative Inflammatory Ileus (EP?)

Objective: To investigate the preventive effect of the jolt therapy and TongfuXiaoyin Decoction on the early postoperative inflammatory ileus(EP?)Method: 400 patients who were diagnosed as acute diffuse peritonitis and who have conducted acute ileus laparotomy were selected and were randomly divided into the Observation Group and the Control Group,each group with 200 patients respectively.In addition to the conventional western medicine treatment,in the postoperative 20-24 h,patients in the Observation Group,were at the prone position and pillows were put under their hips and their upper breast,with the naturally falling of abdominal and the relaxation of abdominal wall muscles.Half dose(100ml)of Tong Fu Xiao Yin Decoction was injected through the stomach tube or taken orally,with an appropriate speed of 15-20 ml per minute.Then stomach tube was occluded for one to two hours.10-20 minutes after taking medicine,the operator put his palm under the patient's middle and lower abdominal,and lifted the abdominal wall gently to a 5-15 cm height.Then put it down.Again,lifted it up and put down.While that process was repeated over and over again,the extent was increased gradually.The force by the operator was determined by the comfortableness of the patient.Having jolting for 10-15 times,the operator can jolt the hips of the patient from left to right.Generally that process lasted for three to five minuses.After 15-30 minutes' interval,the previous process was repeated least twice.Having completed the whole process,the patient had a rest for 30 minutes just on the previous prone position.The process was conducted twice a day for one week.Two to seven days after the surgery,one hour after the jolt therapy,the operator used the common stethoscope to examine the intestinal sound times on the peripheral umbilicus.Every time,the operator auscultated for five minutes and wrote down the intestinal sound times.This process went through once a day.During the same period,the same method was applied in recording the intestinal sound times of the patients in the Control Group.Also recorded the initial time of anus flatus and defecation.The intra-abdominal pressure was examined and recorded on the third,fourth and fifth day.During the one month follow-up visit,the operator examined and recorded the condition of abdominal incision healing,hemorrhage and dehiscence in the perioperative period,to check whether there was ileus manifestation such as abdominal pain,abdominal distension,vomiting,flatus and defecation stopping and other clinical manifestation like gastrointestinal fistula and abdominal infection.Result: All the patient cases in both Groups during the perioperative period,there was no gastrointestinal fistula occurring,no death.Patients in the Observation Group,were found intestinal sound active.Fron the second to seventh day,on average,their intestinal sound per minute 6.4±1.2 every time.The intra-abdominal pressure on the third,fourth and fifth day are 5.86±1.28,5.24±1.22,4.43±1.03.The initial time of anus flatus and defecation was 40.29±5.57(min).The proportion of EP? occurred was 4/195(2.0%).Compared with the Control Group,all the Ps were smaller than 0.05.The differences between the two Groups are meaningful.However,in terms of the first phase of post-operation healing rate,it is more than 0.05(P>0.05),which is of no statistical significance.Conclusion: Jolt therapy has the positive preventive effect on Early Postoperative Inflammatory Ileus(EP?)for patients with acute diffuse peritonitis and acute ileus which are caused by different reasons.This method is simple,safe and reliable.