胃肠三针调神针法联合桂枝茯苓丸对开腹子宫肌瘤剔除术后胃肠功能恢复、应激反应及炎症水平的影响

Study on Effects of Gastrointestinal Three-Needle and Spirit-Regulating Acupuncture Combined with Guizhi Fuling Pill(桂枝茯苓丸)on Gastrointestinal Function Recovery,Stress Response and Inflammatory Level in Patients after Abdominal Myomectomy

目的探讨胃肠三针调神针法联合桂枝茯苓丸对开腹子宫肌瘤剔除术后患者胃肠功能恢复、应激反应及炎症水平的影响。方法收集2021年8月—2022年8月在医院择期进行开腹子宫肌瘤剔除术的53例子宫肌瘤患者,根据随机数字分配法分为试验组(27例)和对照组(26例),对照组予以常规针刺治疗,试验组予以胃肠三针调神针法联合桂枝茯苓丸,所有患者均治疗7 d。对比两组临床疗效、胃肠功能、胃肠激素水平、应激反应、血清炎症因子、不良反应及随访复发率。采用SPSS 23.0软件进行统计学分析。结果治疗后与对照组相比,试验组临床总有效率较高(P<0.05)。与对照组相比,试验组肠鸣音恢复时间、肛门排气、首次排便时间缩短(P<0.05)。与治疗前比,治疗后两组胃泌素(gastrin,GAS)、胃动素(motilin,MTL)水平升高,血管活性肠肽(vasoactive intestinal peptide,VIP)水平降低;与对照组比,治疗后试验组MTL、GAS水平较高,VIP水平较低(P<0.05)。与治疗前比,治疗后两组C-反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平降低;与对照组比,治疗后试验组CRP、IL-6、TNF-α水平较低(P<0.05)。与治疗前比,治疗后两组胰岛素抵抗指数(insulin resistance index,HOMA-IR)及血管阻力指数(vascular resistance index,RI)水平降低;与对照组比,治疗后试验组RI、HOMA-IR水平较低(P<0.05)。两组不良反应发生情况相比,差异无统计学意义(P>0.05)。与对照组相比,试验组复发率较低(P<0.05)。结论胃肠三针调神针法联合桂枝茯苓丸能有效促进开腹子宫肌瘤剔除术后胃肠功能恢复,调节胃肠激素水平,通过调节机体内炎症指标及应激状态提高治疗效果,远期复发率较低,适宜临床应用推广。

Objective To explore the effect of gastrointestinal three-needle and spirit-regulating acupuncture combined with Guizhi Fuling Pill(桂枝茯苓丸)on gastrointestinal function recovery,stress response and inflammatory level in patients after abdominal myomectomy.Methods From August 2021 to August 2022,53 patients with uterine fibroids who underwent elective abdominal myomectomy in the hospital were collected and divided into a trial group(27 cases)and a control group(26 cases)according to a random number allocation method.The control group was treated with conventional acupuncture,and the trial group was treated with gastrointestinal three-needle and spirit-regulating acupuncture combined with Guizhi Fuling Pill.All patients were treated for 7 days.The clinical efficacy,gastrointestinal function,gastrointestinal hormone levels,stress reactions,serum inflammatory factors,adverse reactions and follow-up recurrence rates were compared between the two groups.Statistical analysis was conducted by using SPSS 23.0 statistics.Results After treatment,compared with that of the control group,the total clinical effective rate of the trial group was higher(P<0.05).Compared with the control group,the recovery time of bowel sounds,anal exhaust and first defecation time in the trial group were shortened(P<0.05).Compared with those before treatment,the levels of motilin(MTL)and gastrin(GAS)increased and the vasoactive intestinal peptide(VIP)level decreased in the two groups after treatment.Compared with those of the control group,the level of MTL and GAS in the trial group were higher and the VIP level was lower after treatment(P<0.05).Compared with those before treatment,the levels of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the two groups after treatment were lower.Compared with those of the control group,the levels of CRP,IL-6 and TNF-αin the trail group after treatment were lower(P<0.05).Compared with those before treatment,the levels of vascular resistance index(RI)and insulin resistance index(HOMA-IR)in the two groups decreased after treatment.Compared with those of the control group,the levels of RI and HOMA-IR in the trial group were lower after treatment(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Compared with that of the control group,the recurrence rate in the trial group was lower(P<0.05).Conclusion Gastrointestinal three-needle and spirit-regulating acupuncture combined with Guizhi Fuling Pill can effectively promote the recovery of gastrointestinal function after abdominal myomectomy,regulate the levels of gastrointestinal hormones and improve the quality and effectiveness by regulating inflammation and stress status in the body,and has a low long-term recurrence rate,which is suitable for clinical application.