温阳活血中药外敷治疗消化系统肿瘤术后胃瘫综合征的临床研究

Clinical study on the external application of Wenyang Huoxue Chinese medicine in the treatment of gastroparesis syndrome after operation of digestive system tumor

目的探讨温阳活血中药外敷治疗消化系统肿瘤术后胃瘫综合征的临床疗效。方法选取2015年12月至2018年12月就诊于中国人民解放军总医院第一医学中心的消化系统肿瘤术后胃瘫综合征患者74例,采用随机数字表法分为观察组和对照组,各37例。对照组给予禁食、持续胃肠减压、肠外营养及维持水电解质酸碱平衡等支持治疗,观察组在对照组基础上配合温阳活血中药外敷神阙穴治疗,疗程均为14 d。治疗期间观察组中因出现皮肤瘙痒脱落1例,对照组因个人原因脱落2例,最终观察组纳入36例、对照组纳入35例。比较2组治疗前后的症状积分、Karnofsky功能状态(KPS)评分、胃液引流量改善情况。结果治疗前,2组腹胀、腹痛、恶心呕吐症状积分及KPS评分差异均无统计学意义(均P>0.05)。治疗后,2组腹胀、腹痛、恶心呕吐症状积分均低于治疗前,且观察组均低于对照组[(1.8±1.1)分比(3.3±0.9)分、(1.5±0.8)分比(2.1±0.9)分、(1.8±0.6)分比(2.5±0.8)分],KPS评分均高于治疗前,且观察组高于对照组[(67±7)分比(62±6)分],差异均有统计学意义(均P<0.05)。观察组胃液引流量的总改善率高于对照组,差异有统计学意义(P<0.05)。治疗后2组患者血常规、肝肾功能、心电图指标均未见明显异常改变。结论温阳活血中药外敷治疗消化系统肿瘤术后胃瘫综合征的疗效确切,可以明显改善临床症状,减少胃液引流量,提高KPS评分。

Objective To investigate the clinical efficacy of the external application of Wenyang Huoxue Chinese medicine on the treatment of gastroparesis syndrome(GS)after operation of digestive system tumor.Methods From December 2015 to December 2018,74 patients with GS after operation of digestive system tumor admitted to the First Medical Center,Chinese PLA General Hospital were enrolled.They were randomly divided into the observation group and the control group,with 37 cases in each group.The control group was administered with supportive treatments including fasting,continuous gastrointestinal decompression,parenteral nutrition and maintenance of water-electrolyte acid-base balance.The observation group was treated with external application of Wenyang Huoxue Chinese medicine on the Shenque acupoint based on the control group.Both groups were treated for 14 d.Durng treatment,1 case in the observation group dropped out because of itchy skin and 2 cases in the control group dropped out because of personal reasons.There were 36 cases enrolled in the observation group and35 cases in the control group finally.Symptom scores,Karnofsky performance status(KPS)score and improvement of gastric drainage before and after treatment were compared between the two groups.Results Before treatment,there were no significant differences in symptom scores of abdominal distension,abdominal pain and nausea and vomiting and KPS score between the two groups(all P>0.05).After treatment,symptom scores of abdominal distension,abdominal pain and nausea and vomiting in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group[(1.8±1.1)vs(3.3±0.9),(1.5±0.8)vs(2.1±0.9),(1.8±0.6)vs(2.5±0.8)];KPS scores after treatment in both groups were higher than those before treatment,and that in the observation group was higher than that in the control group[(67±7)vs(62±6)](all P<0.05).Total improvement rate of gastric drainage in the observation group was higher than that in the control group(P<0.05).No significant abnormal changes in blood routine,liver and kidney function or electrocardiogram indexes were observed in both groups after treatment.Conclusion External application of Wenyang Huoxue Chinese medicine has certain curative effect on treating GS after operation of digestive system tumor,which significantly improves the clinical symptoms,reduces gastric drainage and improves KPS score.