足部穴位热熨对结直肠癌患者全麻术后胃肠功能及免疫功能的影响

The effect of foot acupuncture hot medicated compress on immune function and gastrointestinal function in patients with colorectal cancer after general anesthesia

目的全麻术易导致患者术后出现免疫功能低下及胃肠功能紊乱等不良状况,因此,本研究拟探讨足部穴位热熨对结直肠癌患者全麻术后免疫功能及胃肠功能的影响。方法本研究纳入2016年1月-2017年6月在浙江中医药大学附属第二医院行全身麻醉手术切除术的结直肠癌患者74例,将患者按照随机数字表法分为研究组和对照组,每组各37例,对照组采用常规围手术期干预措施,研究组在对照组干预基础上,给予足部冲阳穴、涌泉穴艾盐包热熨。于术前、术后7 d采用酶联免疫吸附法检测2组血清免疫球蛋白(IgG、IgA、IgM)水平,采用流式细胞术检测2组外周血T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)水平,并记录2组患者术后肛门首次排气时间、首次排便时间、胃管留置时间及肠鸣音恢复时间。结果术后7 d研究组患者血清IgG、IgA、IgM水平均较术前和对照组显著升高(均P<0.05)。术后7 d研究组患者外周血CD3+、CD4+、CD4+/CD8+水平较术前和对照组显著升高(均P<0.05),CD8+水平较治疗前和对照组明显降低(均P<0.05)。术后研究组肛门首次排气时间、首次排便时间、胃管留置时间、肠鸣音恢复时间均明显短于对照组,差异具有统计学意义(均P<0.05)。结论足部穴位热熨能明显改善结直肠癌患者全麻术后的免疫功能,有效促进患者术后胃肠功能的恢复。

Objective General anesthesia may cause poor immune function and gastrointestinal dysfunction after the operation. The aim of this study is to explore the effect of foot acupoint hot medicated compress on postoperative immune function and gastrointestinal function among colorectal cancer patients after general anesthesia. Methods From January 2016 to June 2017, 74 patients with colorectal cancer who underwent surgical therapy under general anesthesia in the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, were included in this study. The patients were randomly divided into study group and control group, 37 cases in each group. In the control group, routine perioperative nursing measures were adopted. In the study group, on the basis of the nursing of the control group, the foot Chongyang point and Yongquan point were given hot medicated compress nursing with moxa and salt bag. The levels of serum immunoglobulins(IgG, IgA, IgM) and T lymphocyte subsets(CD3^+, CD4^+, CD8^+, CD4^+/CD8^+) were measured by flow cytometry before and 7 days after operation, and the time of first anal exhaust, first defecation, gastric tube retention and bowel sound recovery were recorded. Results The serum levels of IgG, IgA and IgM of the study group 7 days after the operation were significantly higher than those in the control group and before the operation(all P<0.05). The levels of CD3^+, CD4^+, CD4^+/CD8^+ of the study group 7 days after the operation were significantly higher than those in the control group and before operation(all P<0.05), and the levels of CD8^+ were significantly lower than control group and before treatment(P<0.05). The time of first anal exhaust, first defecation, gastric tube indwelling and recovery of bowel sounds in the study group were significantly shorter than those in the control group(all P<0.05). Conclusion Foot acupuncture hot medicated compress can improve the immune function of colorectal cancer patients after general anesthesia, and effectively promote the recovery of gastrointestinal function.