大承气汤保留灌肠治疗抗精神病药物所致老年动力性肠梗阻临床研究
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Clinical Study on Retention Enema with Dachengqi Tang for Elderly Patients with Dynamic Ileus Caused by Antipsychotic Drugs
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    摘要:

    目的:观察大承气汤保留灌肠治疗抗精神病药物所致老年动力性肠梗阻临床疗效。方法:选取脑器质性疾病所致的精神障碍老年患者,且口服抗精神病药物、住院10 d 以上致使动力性肠梗阻患者82 例,随机分成2 组,大承气汤保留灌肠加口服乳果糖42 例为治疗组,口服乳果糖40 例为对照组。比较2 组治疗效果。结果:治疗组总有效率80.95%,对照组总有效率为42.50%,治疗组疗效优于对照组,差异有统计学意义(P<0.05)。排便治疗组最短为3 h,24 h 内总的排便率为71.43% (30/42)。对照组4 h≤最早排便<24 h,24 h 内排便率20.00% (8/40)。24 h 内排便率比较,治疗组优于对照组,差异有统计学意义(P<0.001)。1 周后排便治疗组19.05%(8/42),对照组57.50%(23/40),差异有统计学意义(P<0.001)。治疗组Karnofsky(KPS) 评分改善率66.67%(28/42) 明显优于对照组45.00%(18/40),2 组比较,差异有统计学意义(P<0.05)。结论:服用抗精神病药物后致动力性肠梗阻在口服乳果糖常规治疗基础上,加用中药大承气汤保留灌肠,能及时缓解患者的症状,有助于提高患者的生活质量。

    Abstract:

    Abstract:Objective:To observe the curative effect of retention enema with modified Dachengqi tang for elderly patients with dynamic ileus caused by antipsychotic drugs. Methods:Eighty-two elderly patients with dynamic ileus who had mental disorders caused by organic brain diseases and hospitalized with oral antipsychotic drugs for more than 10 days were randomly divided into two groups. The treatment group was intervened with retention enema with modified Dachengqi tang and an oral administration of lactulose,including 42 cases. The control group was treated with oral administration of lactulose,including 40 cases. The therapeutic effect was compared between the two groups. Results:The total effective rate was 80.95% in the treatment group and 42.50% in the control group;the one in the treatment group was better than that in the control group, the difference being significant(P<0.05). In the treatment group,the shortest time was 3 h,and the total defecation rate within 24 h was 71.43%(30/42). In the control group,4 h≤the earliest defecation time<24 h,and the defecation rate within 24 h was 20.00% (8/40). The defecation rate within 24 h was better in the treatment group than in the control group, the difference being significant(P<0.001). The defecation rate after a week was 19.05% in the treatment group(8/42) and 57.50% in the control group(23/40), the difference being significant(P<0.001). The improvement rate of score of Karnofsky Performance Scale(KPS) was 66.67% in the treatment group(28/42), significantly better than that of 45.00% in the control group(18/40),the difference being significant(P<0.05). Conclusion:Based on the conventional treatment of oral administration of lactulose, the additional application of retention enema with modified Dachengqi tang for patients with dynamic ileus caused by antipsychotic drug,can alleviate the patient's symptom in time and is helpful to improve their quality of life.

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郭艳宏,丁春红,崔凤娟,王追琴,顾许儿.大承气汤保留灌肠治疗抗精神病药物所致老年动力性肠梗阻临床研究[J].新中医,2020,52(21):19-21

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  • 在线发布日期: 2020-11-05
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