基于Roy模式的中医综合干预方案在结肠癌术后患者中的运用效果

Application effect of the Roy model-based comprehensive intervention plan of Chinese medicine in postoperative patients with colon cancer

目的 制订结肠癌围术期术后中医综合干预方案,并探讨其临床运用价值。方法 将2013年6月～2015年6月广东省中医院外科收治的行结肠癌根治术72例患者随机分为对照组和观察组,其中对照组36例患者采取常规治疗方案,观察组36例患者在常规治疗方案的基础上采用包括耳穴压豆、艾灸及心理干预等中医综合干预方案。比较两组患者肛门排气时间、术后平均住院天数、平均医疗费用及术后并发症发生情况,并收集两组患者干预前后的睡眠质量情况。结果 对照组平均肛门排期时间、术后住院天数、平均医疗费用分别为（79.39±13.05）h、（9.11±1.51）d及（4.51±0.95）万元,均明显高于观察组[（56.61±16.73）h、（6.14±1.38）d及（3.90±0.95）万元],差异均有统计学意义（P〈0.05）。观察组并发症发生率明显低于对照组（11.11%比22.22%,P〈0.05）。观察组干预后的SPIEGEL总分为（9.08±2.37）分,明显低于干预前[（19.50±4.09）分]及同期对照组[（12.42±3.56）分]（P〈0.05）,干预后的SPIEGEL各维度评分均明显低于对照组同期（P〈0.05）。结论 基于Roy模式的中医综合干预方案可改善结肠癌围术期患者的预后,提高睡眠质量,降低术后并发症发生率,值得临床进一步推广。

Objective To make the comprehensive intervention plan of Chinese medicine during the perioperative period of colon cancer and to explore its clinical application value. Methods Seventy two patients undergoing radical operation for colon cancer in Department of Surgery of Guangdong Provincial Hospital of Traditional Chinese Medicine from June 2013 to June 2015 were randomly divided into the control group and the observation group; conventional treatment was performed to 36 cases of patients in the control group, while 36 cases of patients in the observation group were given the comprehensive intervention plan of Chinese medicine based on conventional treatment including auricular point pressing with beans, moxibustion and psychological intervention. The anal exhaust time, average length of stay after oper- ation, average hospitalization costs and occurrence of postoperative complications were compared between the two groups, and sleep quality information of patients in both groups before and after intervention was collected. Results The average anal exhaust time, average length of stay after operation and average hospitalization costs of patients in the control group were （79.39＋13.05） h, （9.11＋1.51） d and （45 100_＋9500） Yuan, which were significantly higher than those of patients in the observation group [（56.61_＋16.73） h, （6.14_＋1.38） d and （39 000_＋9500） Yuan] （P 〈 0.05）, and the occurrence rate of complications in the observation group was obviously lower than that in the control group （11.11% vs 22.22%, P 〈 0.05）; the total SPIEGEL score of patients in the observation group after intervention was （9.08±2.37） points, which was significantly lower than the SPIEGEL score before intervention （19.50±4.09） and the SPIEGEL score of the control group in the same period （12.42±3.56） （P 〈 0.05）. The SPIEGEL score in every dimension after intervention was obviously lower than that of the control group in the same period （P 〈 0.05）. Conclusion The Roy model-based comprehensive intervention plan of Chinese medicine can improve the prognosis and the sleep quality of perioperative patients with colon cancer, and reduce the incidence of postoperative complications, it is worthy to be further promoted clinically.