艾灸对直肠癌术后低位前切除综合征相关腹泻的疗效观察

Effect of Moxibustion on Diarrhea associated with Low Anterior Resection Syndrome after Rectal Cancer Surgery

目的:观察艾灸对直肠癌术后低位前切除综合征(LARS)相关腹泻的临床疗效。方法:选取2019年3月—2020年12月在上海市嘉定区中医医院外科病房就诊的直肠癌术后LARS相关脾虚型腹泻患者80例,根据随机数字表法分为对照组和治疗组,每组40例。对照组口服思密达,1次/d,每次1袋,持续治疗2周;治疗组用艾条温和灸足三里(双)、关元、神阙,每穴20 min,1次/d,持续治疗2周。采用徐氏肛门功能评价、LARS量表评价、中医症候评价以及临床疗效评价,分别对对照组和治疗组停药后1周、2周以及1个月后的情况进行疗效评估。结果:在干预结束第1周后,2组患者在肛门功能、LARS量表、中医症候评分中差异无统计学意义(P>0.05);治疗2周、1个月后,治疗组的肛门功能评分[(6.15±1.97)分、(9.29±0.58)分]高于对照组[(3.99±1.48)分、(4.67±1.74)分],差异有统计学意义(P<0.05);治疗2周、1个月后,治疗组的LARS评分[(15.50±9.61)分、(20.11±9.60)分]低于对照组[(3.94±5.16)分、(16.85±9.57)分],治疗组的中医症候评分[(6.62±3.95)分、(10.09±4.11)分]低于对照组[(3.65±2.66)分、(8.83±4.28)分],差异有统计学意义(P<0.05);在干预结束后,治疗组的有效率为90%,高于对照组的63%,差异有统计学意义(P<0.05)。结论:艾灸可有效改善直肠癌术后LARS相关腹泻患者的肠胃功能,且相比于药物,艾灸的疗效更持久,有效提高了患者的脾胃功能,改善了脾虚症状。

Objective To observe the clinical effect of moxibustion on low anterior resection syndrome(LARS)-related diarrhea after rectal cancer surgery.Methods Patients with LARS related Splenic Deficiency diarrhea after rectal cancer who met the inclusion criteria were randomly divided into control and treatment groups according to the random number table method.The control group was orally administrated with Simida by mouth at a dose of 1 bag once daily for 2 weeks,while the treatment group was moxibusting Zusanli(double),Guanyuan and Shenque by Moxibustion with mug(moxibustion)every point for 20 mins once daily for 2 weeks.Xu’s anal function evaluation,LARS scale evaluation,TCM Syndrome Evaluation as well as clinical efficacy evaluation were used to evaluate the efficacy in the control and treatment groups at 1 week,2 weeks and 1 month after discontinuation of the treatment respectively.Results After the first week of the intervention,the two groups of patients had no significant differences in anal function,LARS scale and TCM syndrome score(P>0.05).After 2 weeks and 1 month of treatment,the anal function score of the treatment group(6.15±1.97 points,9.29±0.58 points)were higher than those of the control group(3.99±1.48 points,4.67±1.74 points),which the difference was statistically significant(P<0.05).After 2 weeks and 1 month of treatment,the LARS score of the treatment group(15.50±9.61 points,20.11±9.60 points)are lower than those of the control group(3.94±5.16 points,16.85±9.57 points),and the TCM syndrome scores of the treatment group(6.62±3.95 points,10.09±4.11 points)are lower than those of the control group(3.65±2.66 points,8.83±4.28 points),which the difference was statistically significant(P<0.05).After the intervention,the treatment effective rate of the treatment group was 90%,which was higher than the control group 63%and the difference was statistically significant(P<0.05).Conclusions Moxibustion can improve the intestinal function of patients with LARS related diarrhea after rectal cancer surgery,and the effect of moxibustion is more long-lasting than that of drugs,which effectively improving the spleen function of patients and improving the symptoms of spleen deficiency.