| Objective:By observing the effect of the traditional Chinese medicine(TCM)ShenBin decoction on the first anal exhaust time and the first defecation time of patients after transabdominal gynecological surgery,and evaluating overall efficacy indicators of postoperative gastrointestinal function recovery and the degree of fatigue of patients,discussing preliminarily the clinical efficacy and safety of ShenBin decoction on the recovery of gastrointestinal function,so as to provide new treatment methods for improving the gastrointestinal function,reducing postoperative complications and promoting the rapid recovery in postoperative patients.Methods:This study adopts a prospective randomized controlled trial design scheme.130 patients are selected in accordance with the inclusion criteria,and the patients are divided into 65 cases in the treatment group and 65 in the control group by simple random method.The treatment group is treated with basic treatment and ShenBin decoction.The control group is only treated with basic treatment.The method of taking ShenBin decoction is as follows:starting taking ShenBin decoction on the first day after surgery,one dose daily frying 200 ml taked on two times warmly(at 9 am,4 pm),each 100 ml,and stopping taking ShenBin decoction after postoperative defecation.Any other drugs and measures that affect the gastrointestinal motility are discontinued during the trial.The visit times are preoperation and the first day,the second day,the third day,the fourth day,the fifth day,the sixth day,the seventh day after surgery(the day before discharge if people discharge early)between 8:00 and 9:00 am.Recording the first time of postoperative exhaust and the first time of postoperative defecation of patients.Evaluating overall efficacy indicators of postoperative gastrointestinal function recovery in every visit time after operation and the degree of fatigue of patients in visit time of preoperation and the first day,the third day.SPSS20.0 statistical software package is used to establish database and carry out statistical analysis.Results:1.Baseline information,there is no significant difference in age,operation time,intraoperative blood loss,preoperative hemoglobin,preoperative blood ALT,preoperative blood albumin,preoperative potassium,preoperative white blood cell count,preoperative platelet,preoperative serum creatinine,operation method,the use of anesthesia and postoperative analgesia pump,pelvic drainage tube indwelling,history of previous abdominal surgery,preoperative VAS score of fatigue between traditional Chinese medicine(TCM)ShenBin decoction group and control group(P > 0.05),the baseline balance between groups is comparable.2.Overall comparison on main efficacy indicators:the first time of postoperative exhaust in the treatment group(26.73±10.13h)is shorter than that in the control group(30.59±11.22h),the first time of postoperative defecation in the treatment group(46.46±18.95h)is shorter than that in the control group(61.12 ± 19.42h).Both of the differences are statistically significant(P<0.05).It is suggested that ShenBin decoction can shorten the time of first exhaust and defecation in patients after gynecological abdominal surgery.3.To compare layeredly on main efficacy indicators,in terms of age,for patients ranging from 40 to 43 years old,there is no significant difference in the first postoperative exhaust time and defecation time between the two groups(P>0.05).For patients ranging from 44 to 65 years old,the first time of postoperative exhaust in the treatment group(25.91±9.25h)is shorter than that in the control group(30.71±10.58h),the first time of postoperative defecation in the treatment group(44.62±17.27h)is shorter than that in the control group(60.43 ± 19.85h).Both of the differences are statistically significant(P<0.05).In terms of surgical methods,laparoscopic surgery patients are performed only for statistical analysis due to the small sample size of laparotomy surgery patients.For patients after laparoscopic surgery,the first time of postoperative exhaust in the treatment group(25.16±9.29h)is shorter than that in the control group(29.5±10.77h),the first time of postoperative defecation in the treatment group(43.37±16.87h)is shorter than that in the control group(58.76 ± 16.67h).Both of the differences are statistically significant(P<0.05).In terms of surgical types,for patients after non-holotropism surgery,there is no significant difference in the first postoperative exhaust time between the two groups(P > 0.05),the first time of postoperative defecation in the treatment group(48.10±20.16h)is shorter than that in the control group(62.94±22.91h),the differences is statistically significant(P < 0.05).For patients after holotropism surgery,the first time of postoperative exhaust in the treatment group(25.95±9.19h)is shorter than that in the control group(30.29±10.10h),the first time of postoperative defecation in the treatment group(45.52±18.39h)is shorter than that in the control group(60.47 ± 18.30h).Both of the differences are statistically significant(P<0.05).In terms of anesthesia,tracheal intubation general anesthesia surgery patients are performed only for statistical analysis due to the small sample size of hemp surgery patients.For patients after tracheal intubation general anesthesia surgery,the first time of postoperative exhaust in the treatment group(26.44 ± 10.24h)is shorter than that in the control group(30.59 ±11.22h),the first time of postoperative defecation in the treatment group(45.67 ± 18.86h)is shorter than that in the control group(61.12 ±19.45h).Both of the differences are statistically significant(P<0.05).In terms of operation time,for patients with no more than 2h operation time,there is no significant difference in the first postoperative exhaust time between the two groups(P > 0.05),the first time of postoperative defecation in the treatment group(42.87±17h)is shorter than that in the control group(60.21±18.66h),the differences is statistically significant(P<0.05).For patients with more than 2h operation time,the first time of postoperative exhaust in the treatment group(27.14±10.76h)is shorter than that in the control group(33.61±11.76h),the first time of postoperative defecation in the treatment group(48.26±19.76h)is shorter than that in the control group(61.7 ± 20.17h).Both of the differences are statistically significant(P<0.05).In terms of pelvic adhesion,for patients without pelvic adhesion,there is no significant difference in the first postoperative exhaust time between the two groups(P>0.05),the first time of postoperative defecation in the treatment group(49.26±18.08h)is shorter than that in the control group(64.66±21.23h),the differences is statistically significant(P<0.05).For patients with membranous adhesion,there is no significant difference in the first postoperative exhaust time and defecation time between the two groups(P>0.05).For patients with dense adhesion,there is no significant difference in the first postoperative exhaust time between the two groups(P>0.05),the first time of postoperative defecation in the treatment group(42.71±16.92h)is shorter than that in the control group(63.34±23.42h),the differences is statistically significant(P<0.05).In terms of intraoperative blood loss,for the blood loss no more than 50 ml,the first time of postoperative exhaust in the treatment group(25.42±10.12h)is shorter than that in the control group(30.59±10.96h),the first time of postoperative defecation in the treatment group(45.63±18.25h)is shorter than that in the control group(61.47±20.16h).Both of the differences are statistically significant(P<0.05).For patients with blood loss more than 50 ml and no more than 400 ml,there is no significant difference in the first postoperative exhaust time and defecation time between the two groups(P> 0.05).4.Postoperative gastrointestinal function restored overall efficacy score:(1)Repeated measurement of variance analysis results show that postoperative gastrointestinal function restored overall efficacy score was significantly changed with the time point.The change of postoperative gastrointestinal function restored overall efficacy score of different groups,patients was not consistent in time.(2)comparison between groups: There is no statistically significant difference in scores on the first day after operation between the treatment group and the control group(P>0.05).The treatment group patients,scores on the second day and the third day after operation are significantly higher than those in the control group,and the difference is statistically significant(P < 0.05).It is suggested that ShenBin decoction can improve the gastrointestinal function of patients after gynecological abdominal surgery on the whole.5.Fatigue level of patients:(1)Repeated measurement of variance analysis results show that fatigue level of patients was significantly changed with the time point.The change of fatigue level of different groups,patients was not consistent in time.(2)comparison between groups: There is no statistically significant difference in fatigue VAS scores on the first day after operation between the two groups(P>0.05).The fatigue VAS score on the third day after operation in the treatment group(2.12±1.77)is significantly lower than that in the control group(3.46±2.12),and the difference is statistically significant(P<0.05).It is suggested that ShenBin decoction can effectively improve the fatigue symptom of patients after gynecological abdominal surgery.6.In terms of postoperative major safety indicators,there is no statistically significant difference in serum potassium,blood leukocyte count,serum creatinine,and serum alanine transaminase in the first and third days after surgery(P<0.05).It is indicated that ShenBin decoction has no obvious effect on blood potassium,blood cell count,liver and kidney work,and it is safe.Conclusion:The results of the study showed that the traditional Chinese medicine(TCM)ShenBin decoction can effectively shorten the time of first exhaust and defecation in patients after gynecological abdominal surgery(P < 0.05),accelerate the overall recovery of gastrointestinal function(P<0.05),and obviously improve the fatigue symptom of patients after gynecological abdominal surgery(P<0.05).ShenBin decoction is of clear clinical efficacy and safe,worthy of further study and clinical promotion. |
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