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