Clinical observation of efficacy in adhesive intestinal obstruction with Integrated Chinese (Chaihu Shugan San, 柴胡疏肝散) and Western Medicine: a randomized controlled trial

doi:10.19852/j.cnki.jtcm.2025.01.010

Abstract

Abstract:

OBJECTIVE: To explore the treatment efficacy of integrated Chinese medicine (Chaihu Shugan San, 柴胡疏肝散, CSS) and western therapy in the treatment of adhesive intestinal obstruction (AIO), to provide new ideas for the management of the disease.

METHODS: In our single-blind randomized controlled study, 120 patients with AIO who were hospitalized in The Affiliated Hospital of China West Normal University Nan Chong Gaoping District People's Hospital from January 2021 to June 2022 and met the inclusion criteria were categorized into the treatment group and the control group. Patients from the control group were administered basic Western Medicine therapy, whereas patients from the treatment group were administered basic Western Medicine therapy plus CSS by gastric tube injection. Subsequently, the time to first anal exhaustion and defecation, time to relief of abdominal distension and pain, days of hospitalization, Traditional Chinese Medicine (TCM) symptom scores, interleukin-6 (IL-6), C-reactive protein (CRP) and procalcitonin (PCT) levels in the 2 groups were recorded and compared.

RESULTS: The comparison of clinical efficacy of the treatment group were better than the control group. The TCM symptom score was considerably lower in the treatment group; the inflammation indicators CRP, IL-6, and PCT also decreased statistically when comparing the control group. Furthermore, there were significantly reduced in the time to first exhaustion, time to first defecation, time to relief of abdominal pain and distension, and days of hospitalization in the treatment group versus the control group.

CONCLUSION: CSS could suppress the inflammatory reaction, reduce days of hospitalization, relieve clinical symptoms in AIO patients with reliable efficacy and high safety and is worthy of clinical application.

Key words: intestinal obstruction, interleukins, C-reactive protein, post-abdominal surgery

ZHANG Xin, CAO Jia, LUO Chengping, FAN Yibin, DU Jie. Clinical observation of efficacy in adhesive intestinal obstruction with Integrated Chinese (Chaihu Shugan San, 柴胡疏肝散) and Western Medicine: a randomized controlled trial[J]. Journal of Traditional Chinese Medicine, 2025, 45(1): 115-122.

Figures/Tables 3

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Variable		n	Treatment group (n = 55)	Control group (n = 44)
Gender	Male	48	25	23
	Female	51	30	21
Age years	< 60	99	48.8±11.7	47.5±11.3
BMI kg/m²			23.8±3.2	23.7±2.9
Chinese Medicine Symptom Score			15.0±1.7	14.9±1.6
Inflammatory indicators	CRP (mg/L)		31.6±22.8	32.7±19.1
	IL-6 (ng/L)		18.0±5.6	17.2±4.2
	PCT (ng/mL)		3.9±1.4	3.9±1.4

Variable		n	Treatment group (n = 55)	Control group (n = 44)
Gender	Male	48	25	23
	Female	51	30	21
Age years	< 60	99	48.8±11.7	47.5±11.3
BMI kg/m²			23.8±3.2	23.7±2.9
Chinese Medicine Symptom Score			15.0±1.7	14.9±1.6
Inflammatory indicators	CRP (mg/L)		31.6±22.8	32.7±19.1
	IL-6 (ng/L)		18.0±5.6	17.2±4.2
	PCT (ng/mL)		3.9±1.4	3.9±1.4

Group	n	Time to first exhaustion (h)	Time to first defecation (h)	Time to relief of abdominal pain (h)	Time to relief of abdominal distension (h)
Control	44	40±12	43±13	98±15	109±19
Treatment	55	30±9	32±9	90±19	116±14
t value		4.950	4.589	2.017	2.108
P value		< 0.0001	< 0.0001	0.0465	0.0376^a

Group	n	Time to first exhaustion (h)	Time to first defecation (h)	Time to relief of abdominal pain (h)	Time to relief of abdominal distension (h)
Control	44	40±12	43±13	98±15	109±19
Treatment	55	30±9	32±9	90±19	116±14
t value		4.950	4.589	2.017	2.108
P value		< 0.0001	< 0.0001	0.0465	0.0376^a

Group	n	Pre-treatment			Third day			Before discharge
Group	n	CRP (mg/L)	IL-6 (ng/L)	PCT (ng/mL)	CRP (mg/L)	IL-6 (ng/L)	PCT (ng/mL)	CRP (mg/L)	IL-6 (ng/L)	PCT (ng/mL)
Treatment	55	31.63±22.76	17.97±5.59	3.86±1.38	7.23±2.81	4.19±1.69	0.36±0.14	7.25±2.79	4.16±1.70	0.36±0.14
Control	44	32.75±19.09	17.18±4.23	3.91±1.40	21.6±12.62	11.10±2.06	2.00±0.76	10.04±3.01	5.90±1.36	0.45±0.13
t value		0.396	0.776	0.183	8.183	18.270	15.510	4.769	5.525	3.143
P value		0.7944	0.4422	0.8553	< 0.0001	< 0.0001	< 0.0001	< 0.0001	< 0.0001	0.0022^a

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