简易推拿法与磷酸肌酸钠联合应用对胃癌术后疲劳综合征的治疗效果

Effect of simple massage method combined with creatine phosphate sodium on postoperative fatigue of patients with gastric cancer

目的评价简易推拿法联合磷酸肌酸钠围手术期应用对胃癌患者术后疲劳综合征（POFS）的治疗效果。方法 90例胃癌患者随机分为简易推拿法联合磷酸肌酸钠组（A组）、磷酸肌酸钠组（B组）、对照组（C组）,每组30例。A组于术中及术后1～3 d给予磷酸肌酸钠静脉输注2 g/d,于术后第1天开始给予简易推拿法按摩1～3 d;B组给予术中及术后1～3 d磷酸肌酸钠静脉输注2 g/d;C组每日静脉滴注等量0.9%氯化钠溶液。各组术后其他治疗措施均相同。记录各组患者的POFS改善情况;于术前、术后1、3、7 d评价患者的疲劳评分（VAS评分）;术前、术后1、3、7 d检测患者血清白介素（IL）-2、C反应蛋白（CRP）、超氧化物歧化酶（SOD）水平。结果 3组对POFS治疗有效率分别为96.67%、83.33%、60.00%,A、B组有效率高于C组（P〈0.05）。3组术后VAS评分较术前显著提高,随时间延长VAS评分下降,A组降低最为明显（P〈0.05）;与术前比较,3组患者术后IL-2、CRP水平均有明显改变,随时间延长而逐渐恢复,A组上述指标的改善均明显优于B、C组（P〈0.05）。术后A、B组血清SOD水平与术前相比无明显改变（P〉0.05）,C组血清SOD水平低于术前（P〈0.05）;术后第7天A、B组SOD水平高于C组（P〈0.05）。结论简易推拿法易于操作,与磷酸肌酸钠联合应用能够有效缓解减轻胃癌POFS,有利于患者术后恢复。

Objective To evaluate the effect of simple massage method combined with creatine phosphate sodium on postoperative fatigue of patients with gastric carcinoma. Methods 90 cases with gastric carcinoma were randomly divided into 3 groups：simple massage method combined with creatine phosphate sodium group（ group A）, creatine phosphate sodium group （group B） ,control group（ group C） ,30 eases in each group. Intravenous drip of phosphocreatine was given introoperation and 1-3d postoperation in group A and B ;simple massage method was applied to group A;group C received normal saline instead. After operation, the two group patients were all treated with same measures. General performance was observed in 3 groups. Fatigue score （VAS） was measured on the day before the operation, the first, third and seventh day after operation. Serum IL-2, CRP,SOD were detected at the same time. Results The total effective rate of 3 groups 96.67%, 83.33%, 60. 00%, respectively,the difference was statistically significant （ P 〈 0.05 ）. VAS scores were significantly increased postoperatively （P 〈 O. 05）. With the extension of time ～AS scores decreased gradually, and change of group A decreased most significantly （ P 〈 0.05 ）. Levels of postoperative IL-2, CRP changed significantly, and levels of postoperative IL-2, CRP recovered gradually with the extension of time, and and change of group A changed most significantly （ P 〈 0.05 ）. Levels of serum SOD in A, B groups postoperatively were no significantly change compared with preoperatively（ P 〉 0.05 ）. Level of serum SOD in group C decreased postoperatively（ P 〈 0.05 ）, and levels of SOD in A, B groups were higher than group C 7th day postoperatively （P 〈 0.05 ）. Conclusion Simple massage method was easy to operate, and combined with creatine phosphate sodium can alleviate postoperative fatigue, and promote rehabilitation of patients.