【作者】 王鹏；

【导师】 张新明；

【作者基本信息】 山东中医药大学 ， 全科医学（专业学位）， 2021， 硕士

【摘要】 目的:观察足三里、三阴交、内关穴位针刺治疗对湿热型腹腔镜阑尾炎术后患者胃肠功能紊乱的临床治疗效果,以期寻求一种对其治疗有效的方法。方法:选择临床诊断为急性化脓性阑尾炎的患者60例,并将受试者随机分成针刺组与对照组,均采取腹腔镜阑尾切除术(laparoscopic appendectomy,LA)。两组受试者在年龄、性别、术中出血量、手术时间方面相较而言未见明显差异(P>0.05)。术后针刺组与对照组均给予常规治疗,包括禁饮食、持续胃肠减压、补液、防止电解质紊乱、维持人体正常酸碱度平衡与抗感染治疗,鼓励患者及早下床适当运动,针刺组在对照组相同治疗方式的基础之上,在足三里、三阴交、内关穴三处行针刺治疗。术后观察患者临床症状和体征,每间隔3h听诊一次肠鸣音,每次听诊时间至少1min,直到肠鸣音次数达到正常标准(≥3次/分),并记录下恢复时间,记录患者术后初次排气、排便时间,记录患者术后6h、24h、48h的中医证候评分,从而推测患者术后胃肠功能紊乱的恢复情况,以探寻针刺治疗对本病治疗的效果,为以后的临床治疗提供一种更佳的方法。结果:经针刺治疗后,针刺组中医证候总积分低于对照组,具有显著的统计学差异(P<0.05);治疗前后效果对比明显高于对照组,差异性显著(P<0.01);针刺组术后肠鸣音恢复正常时间、第一次排气、排便时间相较于对照组而言更早,数据相比差异具有显著性(P<0.01)。结论:针刺足三里、三阴交、内关穴对治疗湿热型腹腔镜阑尾炎术后患者临床症状有良好效果,在肠鸣音恢复、术后排气、排便时间等方面明显提前,对患者术后胃肠功能恢复起到良好的改善效果,疗法具有绿色、安全性,可以在临床中广泛使用。更多还原

【Abstract】 Objective: To observe the clinical therapeutic effect of acupuncture at Zusanli,Sanyinjiao,and Neiguan on patients with damp-heat laparoscopic appendicitis,in order to find an effective method for its treatment.Methods: Sixty patients who were clinically diagnosed as acute suppurative appendicitis were selected,and the subjects were randomly divided into acupuncture group and control group,all underwent laparoscopic appendectomy(laparoscopic appendectomy,LA).There was no significant difference between the two groups in terms of age,gender,surgical blood loss,and operation time(P>0.05).The postoperative acupuncture group and the control group were given conventional treatment,including diet,continuous gastrointestinal decompression,fluid supplementation,prevention of electrolyte disturbances,maintenance of normal p H balance of the human body and anti-infective treatment,encouraging patients to get out of bed and exercise properly.The acupuncture group On the basis of the same treatment in the control group,acupuncture treatment was performed at the Zusanli,Sanyinjiao,and Neiguan points.Observe the clinical symptoms and signs of the patient after the operation.Auscultate the bowel sounds every 3 hours,and the time for each auscultation is at least 1 min until the bowel sounds reach the normal standard(≥3 times/min),and record the recovery time,and record the patient’s postoperative The time of first exhaust and defecation,record the TCM syndrome scores of patients at 6h,24 h,and 48 h after surgery,so as to infer the recovery of gastrointestinal dysfunction after surgery,and explore the effect of acupuncture treatment on the treatment of this disease.Clinical treatment provides a better way.Results: After acupuncture treatment,the scores of TCM syndromes in the acupuncture group were lower than those of the control group,and there was a significant statistical difference(P<0.05);the effect before and after treatment was significantly higher than that of the control group,and the difference was significant(P<0.01)The time for bowel sounds to return to normal,the first time of exhaustion,and defecation in the acupuncture group were earlier than those in the control group,and the difference was significant(P<0.01).Conclusion:Acupuncture at Zusanli,Sanyinjiao and Neiguan points has a good effect on the clinical symptoms of patients after laparoscopic appendicitis of damp-heat type,and it can significantly shorten the recovery of bowel sounds,postoperative exhaust,and defecation time.After the recovery of gastrointestinal function,it has a good improvement effect.The therapy is green and safe,and can be widely used in clinical practice.更多还原