四黄散外敷结合封包照射技术对术后早期炎性肠梗阻的影响及机制研究

目的 探讨在常规治疗的基础上，加用四黄散（Si-Huang-San，SHS）外敷和封包照射技术相结合的治疗手段对术后早期炎性肠梗阻的治疗效果及其作用机制。方法 从临床和动物实验两个层面进行研究。临床病人分为临床常规（c-convention）组和临床四黄散（c-SHS）组两个组：c-convention组患者给予常规西医治疗；c-SHS组在临床常规组的基础上加用腹部外敷四黄散行封包及神灯-TDP照射治疗。大鼠EPISBO造模成功后，将其分为3组，分别为对照（control）组、常规治疗（convention）组、常规治疗加四黄散（SHS）组。结果 c-SHS组病人腹痛缓解时间、胃肠减压引流量、肛门恢复排气时间均较c-convention组减少，有统计学意义（P<0.05）；SHS组大鼠的回肠粘膜损伤显著低于control组和convention组；与大鼠control组、convention组相比，SHS组的24 h小肠推进比明显增加，差异有统计学意义（P<0.05）；与大鼠control组、convention组相比，SHS组大鼠CRP、IL-8 和TNF-α的血清浓度显著降低（P<0.01或P<0.05）。结论 加用腹部外敷四黄散行封包及神灯-TDP照射治疗，可提高对EPISBO的临床疗效，促进小肠蠕动，减轻回肠粘膜损伤，降低炎性肠梗阻大鼠的血清炎症因子水平，为EPISBO的临床治疗提供新的理论基础与实践依据。

EFFECT AND MECHANISM OF EXTERNAL APPLICATION OF SIHUANGSAN COMBINED WITH ENCAPSULATION IRRADIATION TECHNOLOGY ON EARLY POSTOPERATIVE INFLAMMATORY SMALL BOWEL OBSTRUCTION

Objective: To investigate the effect and action mechanism of si-Huang-san(SHS) external application combined with encapsulation irradiation technology on early postoperative inflammatory small bowel obstruction (EPISBO) on the basis of conventional therapy. Methods: Clinical and animal experiments were carried out. Clinical patients were divided into two groups:clinical convention (C-convention) group and clinical Si-Huang -San (C-SHS) group. Patients in C-convention group were given convention western medicine treatment; on the basis of clinical convention group, the c-SHS group was treated with abdominal external application of Si-huang-san powder for encapsulation and shendeng-TDP irradiation. After successful EPISBO modeling, the rats were divided into three groups:control group, convention treatment group, and convention treatment plus Si-Huang-San (SHS) group. Results:The abdominal pain relief time, gastrointestinal decompression drainage volume and anal recovery time in C-SHS group were reduced compared with control group, with statistical significance (P<0.05).The ileum mucosal injury of the rats in SHS group was significantly lower than that in control group and convention group (P<0.05). Compared with the control group and convention group, the 24-hour small intestinal propulsion ratio of the SHS group was significantly increased (P<0.05). Compared with the control group and convention group, the serum concentrations of CRP, IL-8 and TNF in SHS group were significantly decreased (P< 0.01 or P< 0.05). Conclusion: The addition of abdominal external application of Si-huang-san Powder encapsulation and shendeng-TDP irradiation can improve the clinical efficacy of EPISBO, promote small intestinal peristalsis, reduce ileal mucosal injury, reduce the level of serum inflammatory factors in rats with inflammatory ileal obstruction, and provide a new theoretical and practical basis for the clinical treatment of EPISBO.