中药保留灌肠联合针刺治疗在结直肠癌术后的临床运用

Clinical study in the postoperative treatment of colorectal cancer:the combined application of the retention enema with traditional Chinese medicine and acupuncture

[目的]探寻中药保留灌肠联合针刺治疗在结直肠癌术后的临床运用前景。[方法]选择2019年10月-2020年10月因原发性结直肠癌接收并进行根治性切除患者80例,采用随机数字表法随机分为治疗组和对照组,每组40例;试验组予以加味大承气汤保留灌肠联合针刺治疗,对照组予以同温生理盐水灌肠,比较两组患者首次肠鸣音出现时间、肠鸣音恢复正常时间、首次排气时间、首次排便的时间,同期监测患者血清胃动素和生长抑素水平变化。[结果]治疗组首次肠鸣音出现时间、肠鸣音恢复正常时间、首次排气排便时间均早于对照组(P<0.05)。两组患者术后均可见生长抑素水平升高。治疗组第7天的胃动素水平升高同时生长抑素表达降低,与对照组比较具有统计学差异(P<0.05)。[结论]中药保留灌肠联合针刺治疗,可在短期内促进胃肠道蠕动,恢复肠道功能,降低围手术期肠梗阻的发生,值得临床进一步研究与运用。

[Objective]To explore the clinical application prospect in the postoperative treatment of colorectal cancer by using the combined application of the retention enema with traditional Chinese medicine and acupuncture.[Methods]A total of 80 patients with primary colorectal cancer who underwent radical resection in Tianjin People’s Hospital from October 2019 to October 2020 were selected.All the enrolled patients were randomly divided into treatment group and control group,with 40 patients in each group.The experimental group was treated with modified Dachengqi Decoction retention enema combined with traditional Chinese acupuncture,and the control group was treated with same-temperature normal saline enema.The occurrence time of the first bowel sounds,the return time of the bowel sounds to normal,the first exhaust time,and the first defecation time were compared between two groups,and the changes of serum motilin and somatostatin levels were monitored simultaneously.[Results]Compared with the control group,the time of first bowel sounds,the time of bowel sounds returning to normal and the time of first exhaust and defecation in the treatment group were earlier(P<0.05).All patients had elevated levels of somatostatin after surgery.On the 7th day,the level of motilin in the treatment group increased and the expression of somatostatin decreased,which was significantly different from that of the control group(P<0.05).[Conclusion]Treatingthe patients with traditional Chinese medicine retention enema and acupuncture after surgery can promote gastrointestinal peristalsis and restore intestinal function in a short period of time,which is conducive to reduce the occurrence of perioperative intestinal obstruction.Therefore,this therapy is worthy of further clinical study and application.