| Objectives:This study investigated the efficacy of the insertion depth of enema tube and the speed of clyster with QingYi II Decoction on patients with acute pancreatitis(AP)in order to obtain more retention time and contact area of drugs in the intestine,thus promoting drug absorption and improving curative effects of QingYi II Decoction.Methods:A total of 132 patients with acute pancreatitis admitted to the department of Hepatobiliary pancreas surgery of a hospital in Guizhou province during January to October of 2018 were enrolled.All participants were randomly divided into four groups(control group,test group 1,test group 2,and test group 3).There were 33 patients included in each group.All groups were administered with the same integrated traditional Chinese and Western Medicine but with different insertion depth of enema tube and speed of clyster by the retention enema with Qing Yi II Decoction.Patients in control group received enema at the depth of 15-20 cm and the speed of 10-14mL/min;Patients in test group 1 received enema at the depth of 15-20 cm and the speed of 5-9mL/min;Patients in test group 2 and test group 3 both received enema at the depth of 25-30 cm but at the speed of 10-14mL/min and 5-9mL/min respectively.After the first enema,the degree of sensation of defecation,and the degree of cold sensitivity of medicine solution were evaluated.In additition,the medicine retention duration,the defecation frequency and quantity,the duration time of abdominal distension and abdominal pain,the recovery time of intestinal function and fasting duration,and the total times of enema after the first enema were also observed.Results:A total of 120 patitients’ profiles were collected,incuding 29 cases(4 cases wereexcluded)in control group,31 cases(2 cases were excluded)in test group 1,and 30 cases(3 cases were excluded)both in test group 2 and test group 3.The results of the study are presented as follows:1.There were no significant differences in general demographic and disease baseline data of the four groups(P > 0.05).2.The retention time of the medicine after the first enema were 37.34±16.53(min),44.90±13.47(min),65.73±19.63(min)and 70.43±19.34(min)in control group,test group 1,test group 2 and test group 3 respectively.Patients in test group 2 and test group 3 showed longer retention time of the medicine than those in control group and test group 1respectively(P < 0.05).Meanwhile there was no difference of retention time of the medicine neither between control group and test group 1 nor between test group 2 and test group 3(P > 0.05).3.Patients in test group 2 and test group 3 showed more defecation frequency and quantity after the first enema operation than those in control group and test group 1(P < 0.0083),meanwhile there was no significant difference neither between control group and test group 1 nor between test group 2 and test group 3(P > 0.0083).4.Patients in test group 2 and test group 3 appeared to be better in these aspects including duration time of abdominal distension and abdominal pain,the recovery time of intestinal function,the fasting duration and the total times of enema than those in control group and test group 1,the differences were significant(P < 0.0083).Meanwhile there was no significant difference neither between control group and test group 1 nor between test group 2 and test group 3(P > 0.0083).5.Patients in test group 2 and test group 3 showed lower sensation of defecation after the first enema operation than those in control group and test group 2 respectively(P < 0.0083).Meanwhile there was no difference of sensation of defecation neither between control group and test group 1 nor between test group 2 and test group 3(P > 0.0083).6.Patients in control group showed highest degree of the cold sensitivity for medicinesolution,and patients in test group 1 showed higher degree than those test group 2 and test group 3(P < 0.0083),meanwhile there was no difference between test group 2 and test group 3(P > 0.0083).7.There was a moderately positive correlation between the medicine retention time and defecation frequency after the first enema(r = 0.537,P < 0.05),and a weak negative correlation between the medicine retention time and anxiety,depression,and the total score of negative emotion.The Pearson’s r was-0.315,-0.305,-0.335,respectively(P < 0.05).The defecation frequency was negatively correlated with anxiety,depression and the total score of negative emotion,and the Spearman’s r was-0.250,-0.252,-0.268,respectively(P< 0.05).Conclusions:1.The insertion depth of 25-30 cm for enema tube had longer retention time and better curative effect of enema with Qingyi II compared with that of 15-20 cm in patients with acute pancreatitis(AP)at whichever speed of the drug infused into intestinal tract,be the speed 5-9mL/min or 10-14mL/min.2.The infusion speed of Qingyi II(5-9mL/min,10-14mL/min)did not affect the retention time and curative effect of enema with Qingyi II in patients with acute pancreatitis(AP)for different insertion depths of enema tube,be the depth 25-30 cm or 15-20 cm.3.All of anxiety,depression and the total score of negative emotion were negatively correlated with the medicine retention time and the defecation frequency,hence the psychological nursing should be strengthened in order to prolong the retention time and improve the curative effect of Qingyi II before enema. |
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