Clinical Observation Of Subtotal Resection Of The Colon Preserving The Ileocecal Region Combined With Huangqi Decoction In The Treatment Of Slow Transit Constipation

Objective:To observe the clinical effect of subtotal resection of the colon preserving the ileoceal region combined with Huangqi Decoction in the treatment of slow transit constipation,relieve the main clinical symptoms of patients,improving the quality of life,to prevent recurrence of clinical symptoms,complications and sequelae after operation,to provide more clinical data for surgical treatment of constipation.Methods:30 patients who met the diagnostic criteria for slow transit constipation were admitted to general surgery department of Affiliated hospital of Chengdu University of Traditional Chinese Medicine were selected from June 2016 to January 2018.All patients were treated with subtotal resection of the colon preserving the ileoceal region and combined with oral administration of Huangqi Decoction.We detailed record of patient's medical history and constipation score before treatment,follow-up of curative effect after treatment through outpatient review,telephone survey and collection of valid questionnaires.Inform patients of outpatient review and telephone follow-up in March,June and December after treatment.Through analyzing the general data and perioperative conditions of patients before treatment,and the data of defecation condition,postoperative complications,recurrence rate of constipation,quality of life score,patient Satisfaction after treatment.the results of each integral before and after treatment were conducted self-contrast study,and the data were analyzed by paired t test.Results:A total of 30 STC patients selected according to inclusion criteria,including 5 males(16.67%)and 25 females(83.3%).The ratio of males to females was 1:5,female STC patients were significantly more than males.Age ranged from 20 to 70 years with an average age of 46.1years.The average course of constipation was 11.2 years and the average score of Wexner's constipation score was 20.5 before operation.No cardiopulmonary dysfunction was obviously found in 30 patients with STC before operation,four patients(3 females and 1 male)had mild anxiety,while the other 26 patients had no obvious psychological disorders such as anxiety and depression.Among them,6 patients were converted to open surgery,all patients completed the follow-up visit,and no cases fell out.All data were included in the analysis of statistical results.The total curative effect of 30 patients before and after treatment was evaluated(cure + effective),the cure rate was 100%,and the total effective rate was 100%.According to the scoring criteria of main symptoms such as difficulty in defecation,stool characteristics,defecation time and abdominal distension,the defecation scores before and after treatment were calculated and compared.We analyzed by paired t-test,and find t = 10.325,6.745,8.645,P = 0.000 < 0.01.We can conclude that there is statistical significance and significant difference in symptom score between the two groups.It explained that STC patients with subtotal resection of the colon preserving the ileocecal region combined with oral Huangqi decoction can obviously relieving constipation symptoms.Moreover,the average length of hospital stay was short,adverse reactions and complications were few,and the recurrence rate was low and satisfaction was high after treatment.Conclusion:1.The treatment of STC patients with subtotal resection of the colon preserving the ileocecal region combined with oral Huangqi decoction is effective.2.Subtotal resection of the colon preserving the ileocecal region combined with oral Huangqi decoction can significantly improve the clinical symptoms such as difficulty in defecation,Fecal characteristics,Defecation time,Abdominal distension.3.Subtotal resection of the colon preserving the ileocecal region combined with oral Huangqi decoction has fewer complications and lower recurrence rate in the early stage of STC.The clinical effect is satisfactory4.Subtotal resection of the colon preserving the ileocecal region combined with oral Huangqi Decoction is a clinical treatment method with obvious curative effect,fewer complications,lower recurrence rate,relatively safe and reliable in the early postoperative period,which is worthy of wide clinical promotion.