臨床外科68巻12号

2013年11月発行

特集 漢方を上手に使う―エビデンスに基づいた外科診療

周術期管理・合併症と漢方

術後腸管麻痺―大健中湯(DKTフォーラムにおける取り組み)―肝

著者： 草野満夫¹

所属機関： ¹釧路ろうさい病院外科

ページ範囲：P.1294 - P.1301

文献概要

【ポイント】

◆大規模臨床研究にて肝癌肝切除症例において大建中湯の術後の腸管運動改善効果が認められた．

◆抜管から排便までの時間は大建中湯群で88.2時間，プラセボ群で93.1時間と実薬群で有意に短縮した（p＝0.0467）．

◆サブグループ解析では肝障害度（Liver damage）B症例の比較において，大建中湯群はプラセボ群に比して有意差は付かないものの抗炎症効果が確認された．

◆肝癌肝切除症例において，術前からの大建中湯の投与は術後の腸管麻痺を軽減しうるものと考えられた．

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