You S Y, Wu X Z, Liu M L
Dept. of Surgery, First Affiliated Hospital, Tianjin Medical University.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 1994 Sep;14(9):522-4.
In order to elucidate the mechanism of postoperative intestinal dysfunction and the effects of Dachengqui Decoction (DCQD) on it, somatostatin (SS), gastrin (GAS), vasoactive intestinal polypeptide (VIP), substance P (SP), motilin (MOT) and atrial natriuretic peptide (ANP) were determined, frequency and spectrum of peristaltic sound were simultaneously analyzed in 31 subjects undergoing cholecystectomy, the value of pre-, post-operation and post-medication were compared. Plasma SS and MOT decreased postoperatively (P < 0.05), DCQD elevated SS and MOT to higher level than preoperation, VIP, SP increased for half fold (P < 0.05). Gurgling sound diminished after operation, whereas DCQD normalized it. Peak frequency (Fmax) of gurgling ranging from 234.4 to 468.2 Hz preoperatively, mean frequency (FA) was 341.8 +/- 30.9 Hz postoperatively. FA reduced to 322.3 +/- 79.4, DCQD elevated it to 374.2 +/- 57.1 Hz. The result suggested that intestinal motility was disturbed after cholecystectomy, bowel was in dystonic status, accompanying with decreased plasma MOT, DCQD promoted intestinal peristalsis and enhanced it's tonus. The influence of gut peptides might be one of the important pathway that DCQD works.
为阐明术后肠功能障碍的机制及大承气汤(DCQD)对其的影响,对31例行胆囊切除术患者测定了生长抑素(SS)、胃泌素(GAS)、血管活性肠肽(VIP)、P物质(SP)、胃动素(MOT)和心钠素(ANP),同时分析肠蠕动音的频率和频谱,比较术前、术后及用药后的数值。术后血浆SS和MOT降低(P<0.05),DCQD使SS和MOT升高至高于术前水平,VIP、SP升高了0.5倍(P<0.05)。术后肠鸣音减弱,而DCQD使其恢复正常。术前肠鸣音的峰值频率(Fmax)为234.4至468.2Hz,术后平均频率(FA)为341.8±30.9Hz。FA降至322.3±79.4,DCQD将其升高至374.2±57.1Hz。结果提示胆囊切除术后肠道运动受到干扰,肠处于张力障碍状态,伴有血浆MOT降低,DCQD促进肠道蠕动并增强其张力。胃肠肽的影响可能是DCQD发挥作用的重要途径之一。