吴茱萸热熨联合术前区域动脉灌注化疗改善直肠癌患者术后胃肠蠕动功能的效果

Effects of Hot Medicinal Compress Therapy with Wuzhuyu (Euodiae Fructus) Combined with Preoperative Regional Arterial Infusion Chemotherapy on Postoperative Gastrointestinal Peristalsis in Patients with Rectal Cancer

目的:观察吴茱萸热熨联合术前区域动脉灌注化疗改善直肠癌患者术后胃肠蠕动功能的临床疗效。方法:选取2016年10月至2018年8月普外科收治的100例直肠癌患者,根据随机数字表法分为治疗组和对照组,每组50例。两组均接受直肠癌术后常规西医治疗及术前区域动脉灌注化疗,治疗组在此基础上予吴茱萸热熨足三里,比较两组患者治疗后的临床疗效及其他临床指标。结果:治疗组总有效率96.0%,显著高于对照组82.0%(P=0.025)。治疗组肠鸣音恢复时间、首次进食时间、首次肛门排气时间及排便时间均明显短于对照组(P<0.01)。术后第5天,治疗组腹胀分级评分与呕吐分级评分明显低于对照组(P<0.01);治疗组血清胃动素水平显著高于对照组(P<0.01);生长抑素水平明显低于对照组(P<0.01);治疗组生活质量评分显著高于对照组,差异有统计学意义(P=0.000);治疗组整体营养状况明显优于对照组,差异有统计学意义(P<0.05)。结论:吴茱萸热熨联合术前区域动脉灌注化疗能促进直肠癌术后患者胃肠蠕动功能的恢复,有效缓解术后胃肠功能紊乱状态,预防并发症,且安全性高。

Objective:To observe the clinical effects of hot medicinal compress therapy with Wuzhuyu(Euodiae Fructus) combined with preoperative regional arterial infusion chemotherapy on the improvement of postoperative gastrointestinal peristalsis in patients with rectal cancer. Methods:Total 100 patients with rectal cancer in the general surgery department from October 2016 to August 2018 were selected and divided into the treatment group and control group according to the random number table,with 50 cases in each group. The control group received routine western medicine treatment and preoperative regional arterial infusion chemotherapy after rectal cancer operation,while the treatment group received hot medicinal compressing Zusanli(S36) with Wuzhuyu on the basis of the control group. The clinical efficacy and other clinical indicators of the two groups after treatment were compared. Results:The total effective rate of clinical treatment in the treatment group was 96.0%,which was significantly higher than 82.0% in the control group(P= 0.025). The recovery time of bowel sounds in the treatment group,the first feeding time,the first anal exhaust time and the defecation time were significantly shorter than those in the control group(P< 0.01). On the 5 th day after operation,the bloating score and the grading score of vomiting in the treatment group was significantly shorter than those of the control group(P< 0.01). The serum level of motilin in the treatment group was significantly higher than that in the control group(P< 0.01),and the somatostatin level was significantly lower than that in the control group(P< 0.01). The life quality score of the treatment group was significantly higher than that of the control group,and the difference was statistically significant(P= 0.000). The overall nutritional status of the treatment group was significantly better than that of the control group,and the difference was statistically significant(P< 0.05). Conclusions:Hot medicinal compress therapy with Wuzhuyu combined with preoperative regional arterial infusion chemotherapy can promote the recovery of gastrointestinal motility in patients with rectal cancer,effectively relieve postoperative gastrointestinal dysfunction,prevent complications with high safety.