温针灸对结肠癌术后腹腔热灌注化疗患者胃肠道反应的影响

Influence of warming needling technique on gastrointestinal reaction after hyperthermic intrape-ritoneal chemotherapy in patients with postoperation of colon cancer

目的:观察温针灸对脾胃虚弱型结肠癌术后腹腔热灌注化疗(HIPEC)患者胃肠道反应及住院天数的影响。方法:120例HIPEC患者随机分成观察组和对照组,每组60例。两组均接受HIPEC,观察组在HIPEC前1 h温针灸足三里、三阴交、阴陵泉,平补平泻内关,治疗时间30 min,在HIPEC前30 min静脉注射昂丹司琼;对照组在HIPEC前30 min静脉注射昂丹司琼;均连续治疗3 d。观察两组HIPEC后胃肠道反应(恶心、呕吐、腹胀、腹泻)疗效、KPS评分变化、KPS疗效及平均住院天数,全自动生化分析仪检测血清总胆红素(TB)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)。结果:观察组治疗后恶心、呕吐、腹胀、腹泻总有效率为91.67%(55/60)、93.33%(56/60)、80.00%(48/60)、88.33%(53/60),对照组分别为78.33%(47/60)、 78.33%(47/60)、63.33%(38/60)、70.00%(42/60),观察组胃肠道反应总有效率明显高于对照组(P<0.05),KPS评分及疗效明显高于对照组(P<0.05),平均住院天数比对照组明显减少(P<0.05);两组患者治疗后TB、ALT、ALP差异无统计学意义(P>0.05)。结论:温针灸可减轻脾胃虚弱型结肠癌术后HIPEC患者的胃肠道反应,改善KPS评分,减少住院天数。

Objective To observe the effect of warming needling therapy on gastrointestinal reaction after hyperthermic intraperitoneal chemotherapy(HIPEC) in patients of spleen and stomach deficiency syndrome after colon cancer surgery. Methods A total of 120 cases of HIPEC were randomized into observation group and control group, 60 cases in each. The patients of the two groups all received HIPEC. In the observation group, 1 h before HIPEC, warming needling technique was applied to Zusanli(ST36), Sanyinjiao(SP6) and Yinlingquan(SP9) and the even-needing technique of acupuncture was applied to Neiguan(PC6) for 30 min, and then the intravenous injection with Ondansetron was given 30 min before HIPEC. In the control group, The intravenous injection with Ondansetron was given 30 min before HIPEC. In the two groups, the changes in nausea, vomiting, abdominal distention, diarrhea, total bilirubin(TB), alanine aminotransferase(ALT), alkaline phosphatase(ALP) and KPS score, as well as the average hospitalization length of stay were observed. Results The total effective rates in the treatment of nausea, vomiting, abdominal distention and diarrhea were 91.67%(55/60), 93.33%(56/60), 80.00%(48/60) and 88.33%(53/60) in the observation group and were 78.33%(47/60), 78.33%(47/60), 63.33%(38/60) and 70.00%(42/60) in the control group respectively, and the total effective rate in the treatment of gastrointestinal reaction of HIPEC in the observation group was obviously higher than that in the control group(P<0.05). The KPS score and curative effect in the observation group was obviously higher than those of the control group(P<0.05), and the average hospitalization length of stay in the observation group was obviously reduced as compared with the control group(P<0.05). There were no significant differences in serum TB, ALT and ALP contents between the two groups after treatment(P>0.05). Conclusion The warming needling technique of acupuncture and moxibustion alleviates the gastrointestinal reaction, improves KPS score and reduces the hospitalization length of stay in HIPEC patients after the surgery of colon cancer and differentiated as the spleen and stomach deficiency in traditional Chinese medicine.