隔姜百笑灸联合益生菌干预对促进结直肠癌患者术后康复的临床研究

Clinical study on the effect of the intervention of ginger baixiao moxibustion combined with probiotics to promote postoperative recovery of colorectal cancer

目的探讨隔姜百笑灸联合益生菌干预对结直肠癌术后患者免疫功能及肝肾功能的影响,为促进患者术后康复提供理论依据。方法采用随机对照试验方法,以便利抽样法选取2022年6—12月广西医科大学附属肿瘤医院的180例行结直肠癌根治术患者为研究对象,依据随机数字表法将其分为对照组、益生菌组、隔姜百笑灸组、联合组,每组45例。对照组术前、术后采取常规护理;益生菌组在常规护理基础上术前连用3 d益生菌,且术后第1天起连用4 d益生菌;隔姜百笑灸组在常规护理基础上术前连用3 d隔姜百笑灸,且术后第1天起连用4 d隔姜百笑灸进行干预;联合组术前、术后均进行隔姜百笑灸联合益生菌干预,具体干预方法同益生菌组、隔姜百笑灸组。比较4组患者术后免疫功能、肝肾功能等指标的差异。结果4组最终各入组患者45例。对照组男31例,女14例,年龄(56.67±10.13)岁;益生菌组男27例,女18例,年龄(55.33±13.02)岁;隔姜百笑灸组男20例,女25例,年龄(57.87±12.43)岁;联合组男26例,女19例,年龄(57.67±11.63)岁。术后5 d 4组患者的IgA分别为(1.46±0.42)、(1.71±0.49)、(1.72±0.58)、(1.97±0.72)g/L,IgM分别为(0.96±0.20)、(1.13±0.33)、(1.11±0.35)、(1.18±0.52)g/L,IgG分别为(8.45±1.68)、(9.57±1.71)、(9.41±2.14)、(10.40±2.16)g/L,4组比较差异均有统计学意义(F=6.20、10.64、7.69,均P<0.05)。术后5 d 4组的CD3^(+)分别为0.616±0.094、0.671±0.101、0.653±0.119、0.723±0.091,CD4^(+)分别为0.408±0.060、0.444±0.063、0.441±0.103、0.483±0.069,CD4^(+)/CD8^(+)分别为2.173±0.715、2.367±0.963、2.204±1.137、2.803±1.064,4组比较差异均有统计学意义(F=8.58、7.43、3.93,均P<0.05)。术后5 d 4组患者的丙氨酸氨基转移酶分别为(16.22±11.56)、(15.87±10.69)、(12.91±7.45)、(11.31±8.31)U/L,天冬氨酸氨基转移酶分别为(26.13±7.97)、(25.84±7.89)、(25.67±10.85)、(21.84±5.51)U/L,4组比较差异均有统计学意义(F=2.71、2.70,均P<0.05)。结论隔姜百笑灸联合益生菌干预能有效提高结直肠癌术后患者的免疫功能,且在一定程度上改善患者肝功能等指标,使患者获益。

Objective To explore the effects of the intervention of ginger baixiao moxibustion combined with probiotics on immune function,liver and kidney function of colorectal cancer patients after surgery,so as to provide a theoretical basis for clinical intervention methods to promote postoperative rehabilitation of patients.Methods This study was a randomized controlled trial,and 180 patients with colorectal cancer radical resection from the Cancer Hospital of Guangxi Medical University were randomly divided into 4 groups,namely control group,probiotic group,ginger baixiao moxibustion group,and combination group,with 45 cases in each group.The control group was given routine nursing before and after surgery.In the probiotic group,probiotics were used for 3 d in routine preoperative care and 4 d from the first day after surgery.The preoperative routine care of the ginger baixiao moxibustion group was supplemented by ginger baixiao moxibustion for 3 d,and the intervention was carried out on the first day after surgery for 4 d.The combined group was treated with probiotics before and after surgery,and the specific intervention methods were the same as those of the probiotics group and the ginger baixiao moxibustion group.The differences in postoperative immune function,liver and kidney function and and other indexes among the four groups were compared.Results Forty-five cases were ultimately selected from each of the 4 groups.There were 31 males and 14 females,aged(56.67±10.13)years old in the control group.There were 27 males and 18 females,aged(55.33±13.02)years old in the probiotic group.There were 20 males and 25 females,aged(57.87±12.43)years old in the ginger baixiao moxibustion group.There were 26 males and 19 females,aged(57.67±11.63)years old in the combination group.The IgA at 5 d after the operation in the control group,the probiotic group,the ginger baixiao moxibustion group and the combined group were(1.46±0.42),(1.71±0.49),(1.72±0.58),(1.97±0.72)g/L,and the IgM were(0.96±0.20),(1.13±0.33),(1.11±0.35),(1.18±0.52)g/L,and the IgG were(8.45±1.68),(9.57±1.71),(9.41±2.14),(10.40±2.16)g/L,and the differences among the four groups were statistically significant(F=6.20,10.64,7.69,all P<0.05).The CD3^(+)values at 5 d after the operation in the control group,the probiotic group,the ginger baixiao moxibustion group and the combined group were 0.616±0.094,0.671±0.101,0.653±0.119,0.723±0.091,and CD4^(+)were 0.408±0.060,0.444±0.063,0.441±0.103,0.483±0.069,and CD4^(+)/CD8^(+)were 2.173±0.715,2.367±0.963,2.204±1.137,2.803±1.064,and the differences among the four groups were statistically significant(F=8.58,7.43,3.93,all P<0.05).The alanine aminotransferases at 5 d after the operation in the control group,the probiotic group,the ginger baixiao moxibustion group and the combined group were(16.22±11.56),(15.87±10.69),(12.91±7.45),(11.31±8.31)U/L,and the aspartate aminotransferases were(26.13±7.97),(25.84±7.89),(25.67±10.85),(21.84±5.51)U/L,and the differences among the four groups were statistically significant(F=2.71,2.70,both P<0.05).Conclusions The combination of ginger baixiao moxibustion and probiotics intervention can effectively improve the immune function of colorectal cancer patients after surgery,and improve the liver function and other indexes of patients to a certain extent,so as to benefit patients.