OBJECTIVETo observe the effects of Dachengqi Granule (DCG) in the recovery of gastrointestinal function and the condition of patients in the perioperative period of total laparoscopic hysterectomy.

METHODSTwo hundred and one patients received total laparoscopic hysterectomy were assigned to 2 groups, the treated group (103 cases) was orally administered DCG twice, 9 g at 4:00 pm, one day before operation and 6 g at 16 h after operation, while to the control group, enema with 400 mL of soap solution at 8:00 pm one day before operation and acupoint ST 36 injection with 1 mL neostigmine at 16 h after operation were given.

RESULTSTotal laparoscopic hysterectomy was accomplished successfully in all patients, no need to receive open abdominal operation, and with no post-operational complications. In the treated group, the operation time was (116.8 +/- 29.7) min, the operative blood loss was (141.6 +/- 25.1) mL, the post-operative temperature was (37.38 +/- 1.39) degrees C, while those in the control group were (119.6 +/- 28.4) min, (150.6 +/- 22.1) mL, and (37.55 +/- 0.43) degrees C, correspondingly, showing insignificant difference between the two groups (P > 0.05). The white blood cell count on the 1st day after operation was (11.18 +/- 2.93) x 10(9)/L in the treated group, and (12.57 +/- 3.55) x 10(9)/L in the control group (P < 0.01); time for post-operative aerofluxus in them was (35.66 +/- 5.72) h, and (41.77 +/- 6.06) h; time for post-operative defecation (48.47 +/- 18.97) h, and (54.81 +/- 21.30) h, respectively, all showed statistical difference between the two groups (P < 0.01 or P < 0.05).

CONCLUSIONAdministering DCG before and early after operation can effect better than pre-operational enema in ensuring the gynecological operation progression smoothly, and it could also promote the recovery of post-operational gastrointestinal function and improve patients' condition in the perioperative period.

Drugs, Chinese Herbal ; administration & dosage ; Enema ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Neostigmine ; administration & dosage ; Perioperative Period ; Plant Extracts ; administration & dosage

Acute colonic pseudo-obstruction (Ogilvie's syndrome) is characterized by massive dilatation of the colon with no sign of mechanical obstruction. We report a case of eosinophilic peritonitis with severe abdominal pain followed by acute colonic pseudo- obstruction in an ESRD patient on CAPD. The intravenous administration of neostigmine, an acetylcholinesterase inhibitor, resulted in safe and effective colonic decompression in our patient. In case patients with acute colonic pseudo-obstruction do not respond to conservative therapy, treatment with neostigmine can be considered even for patients on dialysis.
Abdominal Pain ; Acetylcholinesterase ; Administration, Intravenous ; Colon* ; Colonic Pseudo-Obstruction* ; Decompression ; Dialysis ; Dilatation ; Eosinophils* ; Humans ; Kidney Failure, Chronic* ; Neostigmine ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

Spinal alpha-2 adrenoceptors and cholinergic receptors are involved in the regulation of acute nociception and the facilitated processing. The aim of this study was to examine the pharmacological effect of an intrathecal alpha-2 agonist and a cholinesterase inhibitor on the facilitated pain model induced by formalin injection and to determine the nature of drug interaction using an isobolographic analysis. Both intrathecal clonidine and neostigmine dose-dependently suppressed the flinching during phase 1 and phase 2. Intrathecal pretreatment with atropine reversed the antinociceptive effects of clonidine and neostigmine in both phases. Pretreatment with intrathecal yohimbine attenuated the effect of clonidine. The antinociception of clonidine and neostigmine was not reversed by mecamylamine. Isobolographic analysis showed that intrathecal clonidine and neostigmine acted synergistically in both phase 1 and 2. Intrathecal pretreatment with atropine and yohimbine antagonized the effect of the mixture of clonidine and neostigmine in both phases, but no antagonism was observed with mecamylamine pretreatment. These data indicate that spinal clonidine and neostigmine are effective to counteract the facilitated state evoked formalin stimulus, and these two drugs interact in a synergistic fashion. In addition, the analgesic action of intrathecal clonidine is mediated by spinal muscarinic receptors as well as alpha-2 adrenoceptors.
Adrenergic alpha-Agonists/*pharmacology ; Analgesics, Non-Narcotic/*pharmacology ; Animal ; Cholinesterase Inhibitors/*pharmacology ; Clonidine/administration & dosage/*pharmacology ; Dose-Response Relationship, Drug ; Drug Synergism ; Formaldehyde ; Injections, Spinal ; Male ; Neostigmine/administration & dosage/*pharmacology ; Pain/drug therapy ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo search for a better therapy for early postoperative inflammatory small bowel obstruction (EPISBO).

METHODSTwo hundred and forty cases were divided into four groups according to admitting order, 60 cases in each group. Routine treatments in western medicine were used in group A including gastrointestinal decompression, parenteral nutrition, anti-infection, supportive therapy and so on. Group B was treated with electroacupuncture in Zusanli (ST 36), Shangjuxu (ST 37) etc. in addition to those given in group A. Group C was treated with acupoint injection with Neostigmine in Dachangshu (BL 25), Zusanli (ST 36) etc. in addition to the treatment used in group A. Group D was treated with all of the treatments used in group A, B and C.

RESULTSThe total effective rate was 93. 3% in group A, 96. 7% in group B, 100.0% in group C and group D. There was no significant difference among the four groups (P>0. 05). The average recovery time of bowel sound was (11. 512. 9) days in group A, (9. 3 +/- 2.5) days in group B, (5.6 +/- 3.5) days in group C and (2. 2 +/- 1.7) days in group D. The average anal exsufflation time was (12. 5 +/- 3. 1) days in group A, (10. 7 +/- 3.6) days in group B, (7. 2 +/- 3. 1) days in group C and (2. 5 +/- 1. 5) days in group D. Group D was superior to those of other three groups obviously, and there were significant differences between them (all P<0. 01).

CONCLUSIONElectroacupuncture combined with acupoint injection has a satisfied therapeutic effect for treatment of EPISBO.

Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Injections ; Intestinal Obstruction ; immunology ; surgery ; Male ; Middle Aged ; Neostigmine ; administration & dosage ; Postoperative Complications ; drug therapy ; immunology ; therapy ; Treatment Outcome