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中国防痨杂志 ›› 2026, Vol. 48 ›› Issue (7): 1030-1037.doi: 10.19982/j.issn.1000-6621.20260125

• 论著 • 上一篇    下一篇

中药内服外用辅助治疗腹腔结核合并肠梗阻的临床研究

李继科1, 罗槑2, 邹莉萍3, 叶庆1, 罗祥一1, 龚蒙萌4, 张慧芳4, 曹玉清4, 傅小燕3, 冯霞1, 周小龙3, 杨映梅1, 庞文箫5, 马艳4(), 吴桂辉3()   

  1. 1 成都市公共卫生临床医疗中心中西医结合科, 成都 610066
    2 成都市公共卫生临床医疗中心精准医疗与转化医学中心, 成都 610066
    3 成都市公共卫生临床医疗中心结核科, 成都 610066
    4 中国中医科学院中医临床基础医学研究所, 北京 100700
    5 成都市公共卫生临床医疗中心科研教学部, 成都 610066
  • 收稿日期:2026-03-11 出版日期:2026-07-10 发布日期:2026-07-02
  • 通信作者: 吴桂辉,Email:wghwgh2584@sina.com;马艳,Email:mayan0825@sina.com
  • 基金资助:
    新发突发与重大传染病防控国家科技重大专项(2026ZD01912900);中央级公益性科研院所基本科研业务费专项资金(ZB2025001);成都市科学技术局技术创新研发项目(2022-YF05-02139-SN);成都市科技局重点研发项目(2024-YF05-00924-SN)

Clinical study on adjuvant therapy of oral and external traditional Chinese medicine for abdominal tuberculosis complicated with intestinal obstruction

Li Jike1, Luo Mei2, Zou Liping3, Ye Qing1, Luo Xiangyi1, Gong Mengmeng4, Zhang Huifang4, Cao Yuqing4, Fu Xiaoyan3, Feng Xia1, Zhou Xiaolong3, Yang Yingmei1, Pang Wenxiao5, Ma Yan4(), Wu Guihui3()   

  1. 1 Department of Integrated Traditional Chinese and Western Medicine, Chengdu Public Health Clinical Medical Center, Chengdu 610066, China
    2 Precision Medicine and Translational Medicine Center, Chengdu Public Health Clinical Medical Center, Chengdu 610066, China
    3 Department of Tuberculosis, Chengdu Public Health Clinical Medical Center, Chengdu 610066, China
    4 Institute of Traditional Chinese Medicine Clinical Basic Medicine, Chinese Academy of Chinese Medical Sciences, Beijing 100700, China
    5 Scientific Research and Teaching Department, Chengdu Public Health Clinical Medical Center, Chengdu 610066, China
  • Received:2026-03-11 Online:2026-07-10 Published:2026-07-02
  • Contact: Wu Guihui, Email: wghwgh2584@sina.com;Ma Yan, Email: mayan0825@sina.com
  • Supported by:
    Prevention and Control of Emerging and Major Infectious Diseases-National Science and Technology Major Project(2026ZD01912900);Basic Scientific Research of Central Public Welfare Research Institutes(ZB2025001);Chengdu Science and Technology Bureau Technology Innovation Research and Development Project(2022-YF05-02139-SN);Key R&D Project of Chengdu Science and Technology Bureau(2024-YF05-00924-SN)

摘要:

目的: 探讨在常规西医治疗基础上,联合中药内服外用对腹腔结核合并肠梗阻患者肠道功能恢复的辅助治疗价值。方法: 采用回顾性队列研究方法,纳入2024年1月1日至12月31日收治的86例腹腔结核合并肠梗阻患者,根据是否应用中药分为中西医结合组与对照组。对照组采用常规西医治疗(规范抗结核、胃肠减压、营养支持及对症治疗),中西医结合组在此基础上加用中医综合治疗方案(中药口服/鼻饲、腹部中药烫熨、中药灌肠)。比较两组患者的腹痛缓解时间、腹胀缓解时间、首次排气/排便时间、肠鸣音恢复时间、影像学改善时间、并发症发生率、因梗阻行腹部手术比例及不良反应发生情况。结果: 共纳入86例患者,其中中西医结合组42例,对照组44例。中西医结合组腹痛缓解时间[30(24,48)h]、腹胀缓解时间[72(48,96)h]、首次排气时间[24(4,24)h]、首次排便时间[48(24,72)h]、肠鸣音恢复时间[42(24,72)h]及腹部影像学液气平大部分消失时间[72(48,96)h]均短于对照组[分别为72(39,96)h、96(54,126)h、48(36,90)h、96(48,120)h、72(48,120)h、96(72,160)h],差异均有统计学意义(Z=481.000,P<0.001;Z=600.000,P=0.004;Z=245.500,P<0.001;Z=377.500,P<0.001;Z=488.000,P<0.001;Z=449.500,P=0.015)。中西医结合组因肠梗阻行腹部手术的比例为9.5%(4/42),低于对照组的20.5%(9/44),差异无统计学意义(χ2=2.001,P=0.157);两组并发症发生率[中西医结合组为57.1%(24/42),对照组为52.3%(23/44)]及不良反应发生率[中西医结合组为23.8%(10/42),对照组为45.5%(20/44)]差异均无统计学意义(χ2=0.206,P=0.650;χ2=1.952,P=0.162)。结论: 在常规西医治疗基础上联合中药内服外用,可明显加快腹腔结核伴肠梗阻患者临床症状的缓解进程,促进肠道功能恢复,显示出潜在临床优势。

关键词: 腹膜炎, 结核性, 肠梗阻, 医学, 中国传统, 对比研究

Abstract:

Objective: To explore the adjuvant therapeutic value of combined oral and external traditional Chinese medicine (TCM) on intestinal function recovery in patients with abdominal tuberculosis complicated with intestinal obstruction on the basis of conventional Western medicine treatment. Methods: A retrospective cohort study was conducted. A total of 86 patients diagnosed with abdominal tuberculosis complicated with intestinal obstruction admitted between January 1, 2024 and December 31, 2024 were enrolled and divided into integrated traditional Chinese and Western medicine group and control group according to whether TCM therapy was applied. Patients in the control group received conventional Western medicine treatment, including standardized anti-tuberculosis therapy, gastrointestinal decompression, nutritional support and symptomatic treatment. On this basis, the integrated medicine group was additionally given comprehensive TCM interventions consisting of oral/nasogastric administration of TCM decoction, abdominal TCM hot compress and TCM enema. The time to relief of abdominal pain and abdominal distension, time to first flatus and defecation, recovery time of bowel sounds, imaging improvement time, incidence of complications, proportion of patients undergoing abdominal surgery due to intestinal obstruction and adverse reactions were compared between the two groups. Results: Among the 86 enrolled patients, 42 cases were assigned to the integrated medicine group and 44 cases to the control group. The median time to abdominal pain relief in the integrated medicine group was 30 (24, 48) h, which was significantly shorter than 72 (39, 96) h in the control group (Z=481.000, P<0.001). Meanwhile, the time to abdominal distension relief (72 (48, 96) h vs. 96 (54, 126) h), time to first flatus (24 (4, 24) h vs. 48 (36, 90) h), time to first defecation (48 (24, 72) h vs. 96 (48, 120) h), recovery time of bowel sounds (42 (24, 72) h vs. 72 (48, 120) h) and time for most disappearance of abdominal gas-fluid levels on imaging examination (72 (48, 96) h vs. 96 (72, 160) h) were all obviously shorter than those in the control group, with statistically significant differences (Z=600.000, P=0.004; Z=245.500, P<0.001; Z=377.500, P<0.001; Z=488.000, P<0.001; Z=449.500, P=0.015 respectively). The proportion of patients receiving abdominal surgery for intestinal obstruction was 9.5% (4/42) in the integrated medicine group, lower than that in the control group (20.5% (9/44)), while no significant difference was observed (χ2=2.001, P=0.157). There were no significant differences in the incidence of complications (57.1% (24/42) vs. 52.3% (23/44)) and adverse reactions (23.8% (10/42) vs. 45.5% (20/44)) between the two groups (χ2=0.206, P=0.650; χ2=1.952, P=0.162). Conclusion: Combined application of oral and external TCM therapy based on conventional Western medicine treatment can significantly accelerate the relief of clinical symptoms and promote the recovery of intestinal function in patients with abdominal tuberculosis complicated with intestinal obstruction, which possesses potential clinical application advantages.

Key words: Peritonitis, tuberculous, Intestinal obstruction, Medicine, Chinese traditional, Comparative study

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