CN103223127B - Traditional Chinese medicine nursing enema fluid used for improving gastrointestinal function after abdominal operation - Google Patents
Traditional Chinese medicine nursing enema fluid used for improving gastrointestinal function after abdominal operation Download PDFInfo
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Abstract
The invention discloses a traditional Chinese medicine nursing enema fluid used for improving a gastrointestinal function after an abdominal operation. The traditional Chinese medicine nursing enema fluid is prepared from the following traditional Chinese medicinal materials in parts by weight: 20-30 parts of dried orange peel, 20-30 parts of salviae miltiorrhizae, 10-20 parts of semen raphani, 10-20 parts of fructus aurantii, 6-12 parts of peach kernel and 40-60 parts of coix seed. The traditional Chinese medicine nursing enema fluid can obviously shorten the first evacuation time, defecation time and borborygmus emergence time of a patient after the abdominal operation.
Description
Technical field
The invention belongs to Chinese medicine technical field, in particular to a kind of Chinese medicine composition that improves abdominal postoperative gastrointestinal function, relate in particular to a kind of Chinese medicine nursing enema that improves abdominal postoperative gastrointestinal function.
Background technology
It is comparatively common complication that abdominal postoperative digestive tract power declines, and the prognosis that is sooner or later directly connected to patient with operation of restoration of gastrointestinal function, is the problem that the doctor of Clinical Surgery is concerned about the most.Abdominal postoperative, can disappear the phase (4～6 hours) through enterokinesia successively, scrambling enterokinesia (12～48 hours) and (after 48 hours) 3 phases intestinal function recovery phase.Therefore patients with abdominal surgery just started progressively to recover gastrointestinal function mostly after 48 hours.Anesthesia, operation, stress, intraperitoneal inflammation or the multifactor effect such as damage, electrolyte disturbance can cause that gastrointestinal function recovery after operation suppresses.Therefore improve as early as possible gastrointestinal function and can promote the discharge of enteric cavity and intraperitoneal liquid, the chance of bacterial translocation is reduced, alleviate endotoxemia.While can promote patient to take food as early as possible, absorbing nourishment is beneficial to postoperative rehabilitation.
Summary of the invention
In order to recover as early as possible the intestinal function of abdominal postoperative, the generation that reduces postoperative intestinal adhesion and block, promote early order rehabilitation of postoperative patient, the object of the invention is to by prescription again after conventional medicament pharmacology is studied, a kind of good effect, instant effect, the Chinese medicine nursing enema that improves abdominal postoperative gastrointestinal function that cost is few are provided.
The object of the present invention is achieved like this:
A kind of Chinese medicine nursing enema that improves abdominal postoperative gastrointestinal function of the present invention, is prepared from by the Chinese crude drug of following weight portion: Pericarpium Citri Reticulatae 20-30 part, Radix Salviae Miltiorrhizae 20-30 part, Semen Raphani 10-20 part, Fructus Aurantii 10-20 part, Semen Persicae 6-12 part, Semen Coicis 40-60 part.
The above-mentioned Chinese medicine nursing enema that improves abdominal postoperative gastrointestinal function, is preferably prepared from by the Chinese crude drug of following weight portion: 25 parts of Pericarpium Citri Reticulataes, 25 parts of Radix Salviae Miltiorrhizaes, 15 parts of Semen Raphanis, 15 parts of Fructus Aurantiis, 8 parts, Semen Persicae, 50 parts of Semen Coiciss.
According to Chinese medicine Historical Data Data About, the pharmacologically active of said medicine material is as follows:
Pericarpium Citri Reticulatae: there is regulating qi-flowing for strengthening spleen, in tune, dampness, the effect of reducing phlegm.Cure mainly the distension and fullness in the abdomen of stagnation of QI in spleen and stomach or pain, dyspepsia.Abdominal distention uncomfortable in chest, indigestion and loss of appetite loose stool in turbid damp resistance.Phlegm-damp is stopped up the cough and asthma of lung.Select the dry mature skin for rutaceae orange and variety thereof.
Radix Salviae Miltiorrhizae: the dry root of selecting dicotyledon Labiatae Labiatae salvia Radix Salviae Miltiorrhizae Salvia miltiorrhiza Bge..There is promoting blood flow to regulate menstruation, stasis-dispelling and pain-killing, removing heat from blood eliminating carbuncle, the relieving restlessness that clears away heart-fire, effect of nourishing blood to tranquillize the mind.Cure mainly menoxenia, amenorrhea dysmenorrhea, lump in the abdomen, breast ventral spine pain, pyretic arthralgia pain, skin infection swells and ache, dysphoria and insomnia; Hepatosplenomegaly, angina pectoris.
Semen Raphani: the de-swelling that helps digestion, lowering the adverse-rising QI to resolve phlegm.Stop up and breath with cough for retention of food and drink, abdominal distention, constipation, stagnant dysentery, expectorant.Enter spleen, stomach, lung meridian, the de-swelling that can help digestion, effect is remarkable, has the title of " rush wall fall wall ".Select the dry mature seed of crucifer Radix Raphani Raphanus sativus L..
Fructus Aurantii: regulating the flow of QI to ease the stomach, the stagnant relieving distension of row.For the breast side of body stagnation of QI, distension pain, accumulation of food in the stomach and intes tine due to indigestion, stops in phlegm retention; Gastroptosis, proctoptosis, sub-official's prolapsus.Select the dry immature fruit of rutaceae Citrus aurantium Linn. Citrus aurantium L. and variety thereof.
Semen Persicae: blood circulation promoting and blood stasis dispelling, loosening bowel to relieve constipation, relieving cough and asthma.For amenorrhea, dysmenorrhea ， WEIJIA mass in the abdomen, injury from falling down, dryness of the intestine constipation.Select the dry mature seed of rosaceous plant Fructus Persicae Prunus persica (L.) Batsch or Prunus davidiana Prunus davidiana (Carr.) Franch..
Semen Coicis: spleen invigorating eliminating dampness by diuresis, eliminating impediment antidiarrheal.Semen Coicis can be used for treating edema, beriberi, dysuria, arthralgia chiefly caused by damp pathogen contracture, diarrhea due to hypofunction of the spleen.
When Chinese medicine nursing enema of the present invention is used for improving the gastrointestinal function of abdominal postoperative, what adopt is coloclysis nursing therapy, during treatment, should be noted following item: before (1) coloclysis, should patient explain coloclysis object to patient, understand patient's thought, in many ways comfort, free one's mind of apprehensions, anxiety at heart.And note ward environment peace and quiet, clean, comfortable, make patient in a good mood.(2) get about 200mL enema, patient gets right arm reclining, with 15～20 centimetres, 1 insertion anus of No. 16 urinary catheters, connects transfusion bottle and slowly allows medicine painting be poured in internal rectum, and patient reposes 2 hours.Every day 2 times.(3) enema temperature is suitable, is sure not overheated excessively coolly, is generally advisable with 38～40 ℃.(4) extract after anal canal, hand-held soft paper is pressed soft anus place gently, and advises the flat bed rest of patient, fully absorbs in order to medicine.(5) after aerofluxus, clean buttocks and anus by warm water, keep sheet, clothing to clean, dry.
The preparation method that above-mentioned each Chinese crude drug is prepared into Chinese medicine nursing enema is:
(1) get Pericarpium Citri Reticulatae 20-30 part, Radix Salviae Miltiorrhizae 20-30 part, Semen Raphani 10-20 part, Fructus Aurantii 10-20 part, Semen Persicae 6-12 part, Semen Coicis 40-60 part, clean roguing, dry, be ground into granule; (2) more above-mentioned graininess medical material is added water and covers powder 2cm, soak 1-1.2h, pull medical material out and put multi-functional extraction and decoct with water secondary in filling with, add up for the first time the water that medical material 8-12 doubly measures, decoct 2h, get decocting liquid, filter, add up for the second time the water that medical material 6-10 doubly measures, decoct 2h, get twice decocting liquid and merge, filter, relative density while being concentrated into 90 ℃ (comparing water) is the concentrated solution of 1.10-1.15; (3) concentrated solution is set to 0 to-5 ℃ of deepfreeze 24h, cold preservation liquid is added to 0.3% filter aid kieselguhr, filter, filtrate reconcentration containing 0.5g crude drug amount, obtains enema to every milliliter.
With herbal retention enema, medicine can directly absorb through intestinal mucosa, plays a role fast, promotes the recovery of Patients after Abdominal intestinal function, and simple to operation, medicine can directly absorb through intestinal mucosa, plays a role fast, has no side effect.Prior, Chinese medicine nursing enema of the present invention is obviously better than matched group to shortening patient evacuation time, defecation time and borborygmus time of occurrence, and the few and effect of full side's taste specially, is the effective prescription that improves abdominal postoperative gastrointestinal function.
The specific embodiment
Be below specific embodiments of the invention, technical scheme of the present invention is done to further description, but protection scope of the present invention is not limited to these embodiment.Every do not deviate from the change of the present invention design or be equal to substitute include within protection scope of the present invention.
Embodiment 1 raw material: 250 grams of Pericarpium Citri Reticulataes, 250 grams of Radix Salviae Miltiorrhizaes, 150 grams of Semen Raphanis, 150 grams of Fructus Aurantiis, 80 grams, Semen Persicae, 500 grams of Semen Coiciss.
Preparation technology:
(1) take the above-mentioned Chinese crude drug of recipe quantity, clean roguing, dry, be ground into granule;
(2) more above-mentioned graininess medical material is added water and covers powder 2cm, soak 1h, pull medical material out and put multi-functional extraction and decoct with water secondary in filling with, add up for the first time the water of 10 times of amounts of medical material, decoct 2h, get decocting liquid, filter, add up for the second time the water of 8 times of amounts of medical material, decoct 2h, get twice decocting liquid and merge, filter the concentrated solution that while being concentrated into 90 ℃, relative density is 1.10;
(3) concentrated solution is put to 4 ℃ of deepfreeze 24h, cold preservation liquid is added to 0.3% filter aid kieselguhr, filter, filtrate reconcentration containing 0.5g crude drug amount, obtains enema to every milliliter.
Embodiment 2 raw materials: 300 grams of Pericarpium Citri Reticulataes, 280 grams of Radix Salviae Miltiorrhizaes, 100 grams of Semen Raphanis, 200 grams of Fructus Aurantiis, 100 grams, Semen Persicae, 600 grams of Semen Coiciss.
Preparation technology:
(1) take the above-mentioned Chinese crude drug of recipe quantity, clean roguing, dry, be ground into granule;
(2) more above-mentioned graininess medical material is added water and covers powder 2cm, soak 1h, pull medical material out and put multi-functional extraction and decoct with water secondary in filling with, add up for the first time the water of 12 times of amounts of medical material, decoct 2h, get decocting liquid, filter, add up for the second time the water of 10 times of amounts of medical material, decoct 2h, get twice decocting liquid and merge, filter the concentrated solution that while being concentrated into 90 ℃, relative density is 1.10;
(3) concentrated solution is put to 2 ℃ of deepfreeze 24h, cold preservation liquid is added to 0.3% filter aid kieselguhr, filter, filtrate reconcentration containing 0.5g crude drug amount, obtains enema to every milliliter.
Embodiment 3 raw materials: 200 grams of Pericarpium Citri Reticulataes, 200 grams of Radix Salviae Miltiorrhizaes, 200 grams of Semen Raphanis, 100 grams of Fructus Aurantiis, 120 grams, Semen Persicae, 400 grams of Semen Coiciss.
Preparation technology:
(1) take the above-mentioned Chinese crude drug of recipe quantity, clean roguing, dry, be ground into granule;
(2) more above-mentioned graininess medical material is added water and covers powder 2cm, soak 1h, pull medical material out and put multi-functional extraction and decoct with water secondary in filling with, add up for the first time the water of 10 times of amounts of medical material, decoct 2h, get decocting liquid, filter, add up for the second time the water of 10 times of amounts of medical material, decoct 2h, get twice decocting liquid and merge, filter the concentrated solution that while being concentrated into 90 ℃, relative density is 1.15;
(3) concentrated solution is put to 5 ℃ of deepfreeze 24h, cold preservation liquid is added to 0.3% filter aid kieselguhr, filter, filtrate reconcentration containing 0.5g crude drug amount, obtains enema to every milliliter.
Embodiment 4
Screen case by following requirement: the patient of abdominal postoperative, stomachache, abdominal distention, vomiting, anus stop defecation aerofluxus and exceed 24 hours, hypoactive bowel sounds or disappearance, in x line abdominal part perspective or plain abdominal radiograph prompting small intestinal flatulence, small intestinal, multiple little liquid is flat.Get rid of gastroenterostomy.
46 routine patients are divided into two groups at random, wherein treatment group 25 examples, the age is at 25～63 years old, average (43.1 ± 15.7) year; Matched group 21 examples, the age is at 24～61 years old, average (42.8 ± 16.2) year.Above two groups of case ordinary circumstances learn by statistics process there was no significant difference (
p>0.05), there is comparability.
Matched group gives fasting to be prohibited water, gastrointestinal decompression, intravenous nutrition, antibiotic therapy, presses down the conventional therapies such as pancreatin, proton pump inhibitor.Treatment group, on the basis of matched group conventional therapy, adds with Chinese medicine high retension enema nursing for treating.Get the about 200mL of the enema of preparing by the embodiment of the present invention 1, medicine temperature is 38～40 ℃.When operation, patient gets lateral position, and medicinal liquid is poured in enemator, with the lubricated anal canal front end of aseptic paraffin oil, drains after air, inserts 15～20cm gently from anus, slowly injects.End of operation, advises patient to repose and retains 2 hours.Every day 2 times.Patiently before nursing coloclysis explain coloclysis object to patient, understand patient's thought, in many ways comfort, free one's mind of apprehensions, nervous psychology.And note the peace and quiet, clean, comfortable of ward environment making patient in a good mood.When operation, action is soft, avoids damaging anorectal mucosa, and when coloclysis, buttocks is raised 10 ° and made medicinal liquid be easy to retain, and anal canal insertion depth is generally 15～20cm, adopts left lateral position more, also can use right arm reclining.Pressure should be low, flow velocity should be slowly in order to avoid rectum irriate and medicinal liquid is excreted.Extract after anal canal, hand-held soft paper rubs anus place gently, and advises the flat bed rest of patient, fully absorbs in order to medicine.If any skin injury, available vaseline is protected.After aerofluxus, with the clean buttocks of warm water and anus, keep sheet, clothing to clean, dry.
In clinical care, observe conditions of patients and change, record borborygmus time of occurrence, first micturition time, postoperative defecation time is as the standard of curative effect evaluation first.After above-mentioned treatment, treatment group aerofluxus first, defecation time obviously shorten compared with matched group, two groups relatively have utmost point significant difference (
p< 0.01), treatment group borborygmus time of occurrence compared with matched group have significant difference (
p< 0.05), specifically in table 1.
Table 1 coloclysis nursing curative effect comparison (h)
| Group | Case load | Borborygmus time of occurrence | Evacuation time first | Defecation time first |
| Matched group | 21 | 13.12±4.30 | 41.33±8.37 | 60.52±14.08 |
| Treatment group | 25 | 8.03±2.94 * | ?30.51±5.84 ** | 42.65±8.94 ** |
Compared with matched group,
* p< 0.05,
* p< 0.01.
Claims (2)
1. improve a Chinese medicine nursing enema for abdominal postoperative gastrointestinal function, it is characterized in that being prepared from by the traditional Chinese medicinal material raw materials of following weight portion: 25 parts of Pericarpium Citri Reticulataes, 25 parts of Radix Salviae Miltiorrhizaes, 15 parts of Semen Raphanis, 15 parts of Fructus Aurantiis, 8 parts, Semen Persicae, 50 parts of Semen Coiciss.
2. the preparation method of the Chinese medicine nursing enema that improves abdominal postoperative gastrointestinal function according to claim 1, is characterized in that comprising the steps:
(1) get raw material Pericarpium Citri Reticulatae, Radix Salviae Miltiorrhizae, Semen Raphani, Fructus Aurantii, Semen Persicae, Semen Coicis, clean roguing, dry, be ground into granule;
(2) more above-mentioned graininess medical material is added water and covers powder 2cm, soak 1-1.2h, pull medical material out and put in multi-function extractor and decoct with water secondary, add up for the first time the water that medical material 8-12 doubly measures, decoct 2h, get decocting liquid, filter, add up for the second time the water that medical material 6-10 doubly measures, decoct 2h, get twice decocting liquid and merge, filter, while being concentrated into 90 ℃, relative density is compared the concentrated solution that water is 1.10-1.15;
(3) concentrated solution is set to 0 to-5 ℃ of deepfreeze 24h, cold preservation liquid is added to 0.3% filter aid kieselguhr, filter, filtrate reconcentration containing 0.5g crude drug amount, obtains enema to every milliliter.
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