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©The Author(s) 2023.
World J Clin Cases. Feb 6, 2023; 11(4): 830-843
Published online Feb 6, 2023. doi: 10.12998/wjcc.v11.i4.830
Published online Feb 6, 2023. doi: 10.12998/wjcc.v11.i4.830
Table 1 All ingredients of the different treatment group
Group | Ingredient |
Control | Warm boiled water |
XD | Dahuang (Rhubarb) 6 g, Houbu (Magnolia officinalis) 6 g and Zhishi (Immature Bitter Orange) 12 g |
MXD | Dahuang (Rhubarb) 6 g, Houbu (Magnolia officinalis) 6 g, Zhishi (Immature Bitter Orange) 12 g, Huangqi (Astragalus) 20 g, Ruxiang (Frankincense) 6 g and Moyao (Myrrh) 6 g |
Table 2 Basic characteristics of the participants
Characteristics/group | Control (n = 53) | XD (n = 54) | MXD (n = 55) | P value |
Age (yr) | 57.19 ± 13.19 | 55.44 ± 15.75 | 54.53 ± 15.36 | 0.640 |
Sex | 0.782 | |||
Male | 23 (43.4%) | 26 (48.1%) | 24 (43.6%) | |
Female | 30 (56.6%) | 28 (51.9%) | 31 (56.4%) | |
BMI (kg/m2) | 23.84 ± 1.85 | 23.78 ± 2.01 | 24.06 ± 1.64 | 0.701 |
Concomitant disease | 0.917 | |||
Yes | 30 (56.6%) | 28 (51.9%) | 29 (52.7%) | |
No | 23 (43.4%) | 26 (48.1%) | 26 (47.3%) | |
Operation mode | 0.997 | |||
Laparoscopic cholecystectomy | 45 (84.9%) | 46 (85.2%) | 47 (85.5%) | |
Laparoscopic cholecystectomy and choledocholithotomy | 8 (15.1%) | 8 (14.85%) | 8 (14.5%) | |
Operation time (min) | 176.70 ± 47.02 | 178.89 ± 47.13 | 173.09 ± 49.36 | 0.816 |
Intraoperative blood loss (mL) | 37.36 ± 22.80 | 37.04 ± 19.97 | 36.36 ± 19.94 | 0.969 |
Table 3 Recovery of gastrointestinal function after biliary surgery
Parameters | Control (n = 53) | XD (n = 54) | MXD (n = 55) | P value |
Bowel sounds (times/min) | ||||
2 h before surgery | 4.66 ± 0.68 | 4.39 ± 0.86 | 4.42 ± 0.79 | 0.144 |
0 h after surgery | 0.02 ± 0.141 | 0.06 ± 0.231 | 0.15 ± 0.361,2 | 0.035 |
6 h after surgery | 2.21 ± 1.321 | 3.11 ± 1.571,2 | 3.24 ± 1.621,2 | 0.001 |
12 h after surgery | 3.77 ± 1.661 | 6.74 ± 1.991,2 | 7.65 ± 2.151,2,3 | 0.000 |
24 h after surgery | 3.95 ± 1.141 | 4.85 ± 1.391,2 | 5.18 ± 1.531,2 | 0.000 |
Time of first flatus (h) | 24.00 ± 11.03 | 19.70 ± 10.212 | 17.40 ± 5.312 | 0.003 |
Time of first defecation (h) | 55.75 ± 26.95 | 36.91 ± 15.202 | 34.42 ± 12.92 | 0.000 |
Table 4 Diet after biliary surgery
Parameters | Control (n = 53) | XD (n = 54) | MXD (n = 55) | P value |
Postoperative drinking time (h) | 11.11 ± 7.26 | 8.88 ± 3.931 | 7.21 ± 3.201 | 0.076 |
Postoperative liquid diet time (h) | 15.72 ± 8.98 | 12.74 ± 5.471 | 10.35 ± 4.241 | 0.049 |
Postoperative semi-liquid diet time (h) | 27.92 ± 15.16 | 22.53 ± 9.331 | 17.98 ± 6.831,2 | 0.028 |
Postoperative normal diet time (h) | 100.94 ± 39.04 | 94.80 ± 35.86 | 81.69 ± 29.07 | 0.333 |
Table 5 Physical activity after biliary surgery
Activity indicators | Control (n = 53) | XD (n = 54) | MXD (n = 55) | P value |
Activity time (min) | ||||
1 d after surgery | 27.06 ± 8.29 | 28.50 ± 8.95 | 33.76 ± 12.411,2 | 0.107 |
2 d after surgery | 41.73 ± 11.59 | 48.07 ± 14.571 | 57.02 ± 19.911,2 | 0.157 |
3 d after surgery | 50.94 ± 12.00 | 61.91 ± 21.731 | 63.64 ± 19.631 | 0.201 |
4 d after surgery | 59.24 ± 12.81 | 68.75 ± 19.54 | 78.08 ± 35.141 | 0.130 |
5 d after surgery | 77.40 ± 21.77 | 85.17 ± 27.81 | 88.80 ± 22.32 | 0.481 |
Activity distance (m) | ||||
1 d after surgery | 256.70 ± 94.97 | 284.57 ± 80.77 | 344.35 ± 134.011,2 | 0.127 |
2 d after surgery | 397.19 ± 123.24 | 480.70 ± 163.851 | 630.60 ± 177.831,2 | 0.050 |
3 d after surgery | 505.19 ± 151.09 | 571.75 ± 177.87 | 730.21 ± 200.951,2 | 0.013 |
4 d after surgery | 651.82 ± 181.59 | 742.75 ± 195.40 | 782.69 ± 159.86 | 0.219 |
5 d after surgery | 788.27 ± 236.58 | 792.50 ± 195.48 | 937.10 ± 145.73 | 0.162 |
Table 6 Incidence of complications after biliary surgery
Parameters | Control (n = 53) | XD (n = 54) | MXD (n = 55) | P value |
Incision complications | 2 (3.77%) | 1 (1.85%) | 1 (1.82%) | 0.761 |
Intra-abdominal infection | 1 (1.89%) | 0 (0%) | 0 (0%) | 0.761 |
Deep-vein thrombosis | 0 (0%) | 0 (0%) | 0 (0%) | 1.000 |
Bile leakage | 1 (1.89%) | 1 (1.85%) | 0 (0%) | 0.599 |
Nausea and vomiting | 12 (22.64%) | 3 (5.56%)1 | 2 (3.64%)1 | 0.001 |
Bloating | 11 (20.75%) | 4 (7.41%)1 | 3 (5.45%)1 | 0.009 |
Table 7 Incidence of functional diarrhea in perioperative period
Parameters | Control (n = 53) | XD (n = 54) | MXD (n = 55) | P value |
1d before surgery | 2 (3.77%) | 14 (25.93%)1 | 6 (10.91%)1,2 | 0.003 |
1d after surgery | 1 (1.89%) | 9 (16.67%)1 | 6 (10.91%)1 | 0.035 |
2 d after surgery | 0 (0%) | 8 (14.81%)1 | 5 (9.09%)1 | 0.017 |
3 d after surgery | 2 (3.77%) | 4 (7.41%) | 2 (3.64%) | 0.595 |
4 d after surgery | 1 (1.89%) | 2 (3.70%) | 1 (1.82%) | 0.777 |
5 d after surgery | 2 (3.77%) | 1 (1.85%) | 2 (3.64%) | 0.816 |
Table 8 Levels of the indicators for acute inflammatory stress response and substance P in the perioperative period of biliary tract surgery
Indicators | Control (n = 53) | XD (n = 54) | MXD (n = 55) | P value |
IL-6 (pg/mL) | ||||
1 d before surgery | 4.89 ± 1.24 | 4.43 ± 1.46 | 4.26 ± 2.62 | 0.203 |
1 d after surgery | 17.42 ± 6.671 | 10.63 ± 9.991,2 | 9.08 ± 8.631,2 | 0.000 |
2 d after surgery | 11.09 ± 3.571 | 9.80 ± 6.511 | 6.13 ± 3.601,2,3 | 0.000 |
5 d after surgery | 8.49 ± 2.311 | 7.22 ± 2.171 | 7.22 ± 3.391 | 0.487 |
IL-10 (pg/mL) | ||||
1 d before surgery | 1.29 ± 0.50 | 1.25 ± 0.46 | 1.24 ± 0.23 | 0.798 |
1 d after surgery | 1.27 ± 0.49 | 1.20 ± 0.61 | 1.21 ± 0.50 | 0.761 |
2 d after surgery | 1.21 ± 0.51 | 1.23 ± 0.50 | 1.19 ± 0.37 | 0.942 |
5 d after surgery | 1.33 ± 0.55 | 1.45 ± 0.53 | 1.39 ± 0.42 | 0.865 |
CRP (ng/mL) | ||||
1 d before surgery | 6.19 ± 1.77 | 5.69 ± 2.40 | 5.59 ± 1.87 | 0.273 |
1 d after surgery | 16.85 ± 7.731 | 10.84 ± 8.381,2 | 8.02 ± 3.441,2,3 | 0.000 |
2 d after surgery | 17.90 ± 17.361 | 14.41 ± 11.361 | 8.83 ± 2.841,2,3 | 0.001 |
5 d after surgery | 10.33 ± 3.111 | 10.49 ± 1.45 | 8.52 ± 2.68 | 0.170 |
SAA (ng/mL) | ||||
1 d before surgery | 426.21 ± 48.96 | 415.64 ± 40.60 | 411.00 ± 47.39 | 0.214 |
1 d after surgery | 9492.64 ± 1738.161 | 7807.52 ± 936.931,2 | 6953.98 ± 1228.381,2,3 | 0.000 |
2 d after surgery | 14792.13 ± 6501.471 | 10573.74 ± 4074.711,2 | 9341.03 ± 1888.411,2 | 0.000 |
5 d after surgery | 7817.09 ± 550.521 | 7396.66 ± 611.021 | 6911.41 ± 1464.141 | 0.132 |
Substance P (pg/mL) | ||||
1 d before surgery | 40.73 ± 21.53 | 35.61 ± 19.79 | 36.14 ± 31.12 | 0.501 |
1 d after surgery | 33.60 ± 16.051 | 37.30 ± 16.07 | 49.25 ± 41.491,2,3 | 0.009 |
2 d after surgery | 28.23 ± 11.121 | 45.58 ± 24.071,2 | 51.73 ± 26.871,2 | 0.000 |
5 d after surgery | 28.29 ± 11.90 | 27.55 ± 23.99 | 35.48 ± 23.70 | 0.653 |
Table 9 Spearman correlation between indicators of gastrointestinal function and inflammation on the second day after surgery (r, p)
Parameters | IL-6 | IL-10 | CRP | SAA | Substance P |
Bowel sounds at 12 h after surgery | (0.25, ≤ 0.001) | (-0.03, 0.74) | (-0.22, ≤ 0.001) | (-0.33, ≤ 0.001) | (0.31, ≤ 0.001) |
Time of first flatus | (0.20, 0.01) | (0.05, 0.55) | (0.35, ≤ 0.001) | (0.16, 0.04) | (-0.23, ≤ 0.001) |
Time of first defecation | (0.14, 0.07) | (0.04, 0.59) | (0.30, ≤ 0.001) | (0.24, ≤ 0.001) | (-0.25, ≤ 0.001) |
Postoperative liquid diet time | (0.19, 0.01) | (-0.02, 0.81) | (0.27, ≤ 0.001) | (0.08, 0.33) | (-0.10, 0.23) |
Postoperative semi-liquid diet time | (0.09, 0.25) | (-0.00, 0.98) | (0.29, ≤ 0.001) | (0.11, 0.15) | (-0.15, 0.06) |
Substance P | (-0.20, 0.01) | (-0.15, 0.06) | (-0.15, 0.05) | (-0.24, ≤ 0.001) | (1.00, ≤ 0.001) |
- Citation: Sun BF, Zhang F, Chen QP, Wei Q, Zhu WT, Ji HB, Zhang XY. Improvement of inflammatory response and gastrointestinal function in perioperative of cholelithiasis by Modified Xiao-Cheng-Qi decoction. World J Clin Cases 2023; 11(4): 830-843
- URL: https://www.wjgnet.com/2307-8960/full/v11/i4/830.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v11.i4.830