锡类散、甲硝唑、庆大霉素联合地塞米松保留灌肠治疗直肠前切除综合征的临床研究

A clinical study of Xilei Powder,metronidazole,gentamicin combined with dexamethasone retention enema to treat low anterior rectal resection syndrome

目的研究锡类散、甲硝唑、庆大霉素联合地塞米松保留灌肠治疗直肠前切除综合征的临床疗效。方法纳入2017年1月至2018年5月就诊于河北医科大学第四医院外二科行直肠癌根治性保肛术后出现直肠前切除综合征的患者88例作为研究对象。按随机数字表法分为观察组(n=44)和对照组(n=44),对照组采用术后常规教育、饮食调节、扩肛等常规治疗,观察组在此基础上给予锡类散、甲硝唑、庆大霉素联合地塞米松保留灌肠治疗。比较两组患者治疗前后直肠前切除综合征(LARS)评分、五羟色胺水平(5-HT)情况。结果观察组LARS评分量表分值明显低于对照组,差异具有统计学意义(t=7.218,P<0.05);观察组5-HT表达水平明显高于对照组,差异具有统计学意义(χ^(2)=9.639,P<0.05)。结论锡类散、甲硝唑、庆大霉素联合地塞米松保留灌肠治疗直肠前切除综合征具有较好的临床疗效,其作用机理可能与药物刺激直肠黏膜释放5-HT类物质,调节排便功能相关。

Objective To study the clinical efficacy of Xilei powder,metronidazole,gentamicin combined with dexamethasone retention enema for low anterior rectal resection syndrome.Methods A total of 88 patients who had low anterior resection syndrome after undergoing low anus-preserving radical rectal cancer surgery in the fourth hospital of Hebei medical university from January 2017 to May 2018 were included as study subjects.According to the random number table method,they were divided into the observation group(n=44)and the control group(n=44).The control group was treated with conventional postoperative education,diet adjustment,and anal expansion.The observation group was given Xilei Powder,metronidazole,gentamicin combined with dexamethasone retention enema on this basis.The low anterior resection syndrome(LARS)score,serotonin level(5-HT)were compared between the two groups of patients.Results The score of the low anterior resection syndrome(LARS)scale in the observation group was significantly lower than that in the control group,and the difference was statistically significant(t=7.218,P<0.05);the expression of 5-HT in the observation group was significantly higher than that in the control group,and the difference was statistically significant(χ^(2)=9.639,P<0.05).Conclusion Xilei powder,metronidazole,gentamicin combined with dexamethasone retention enema has good clinical efficacy in treating rectal resection syndrome,and its mechanism of action may be related to drugs that stimulate the release of 5-HT substances in the rectal mucosa and regulate defecation.