自拟清腹通排汤联合中西医结合护理对胃癌术后胃肠道功能影响
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摘要
目的:探讨胃癌患者术后给予自拟清腹通排汤联合中西医结合护理对胃肠道功能的影响。方法:将2016年3月—2018年3月收治的80例胃癌术后患者借助简单随机化方法分为常规组与试验组,各包含40例对象。常规组术后给予常规西医治疗和西医护理,试验组术后给予常规组方案配合自拟清腹通排汤和中医护理,对比术后首次排气时间、首次排便时间、胃管拔除时间、进食时间,干预期间腹胀发生率及发生程度,两组胃肠道功能改善效果,胃肠道功能恢复相关的并发症情况。结果:试验组术后首次排气时间、首次排便时间、胃管拔除时间及进食时间均短于常规组(P<0.05);两组干预期间腹胀发生程度分布差异显著(P<0.05),且试验组腹胀发生率明显低于常规组(P<0.05);两组干预后营养状态变化分布差异显著(P<0.05),且试验组恶化率明显低于常规组(P<0.05);试验组胃肠道功能恢复不良事件发生率明显低于常规组(P<0.05)。结论:对胃癌患者术后给予自拟清腹通排汤联合中西医结合护理能够加快胃肠道功能恢复,降低腹胀发生率并减轻腹胀程度,改善营养状态,减少胃肠道功能恢复不良事件。
Objective:To explore the effect of self-made Qingfu Tongpai Decoction combined with integrated traditional Chinese and Western medicine on gastrointestinal function after gastric cancer operation. Methods:80 cases of postoperative gastric cancer treated in our hospital from March 2016 to March 2018 were divided into two groups by simple randomization. Each includes 40 objects. The routine group was given routine Western medicine and Western medicine nursing after operation,while the experimental group was given self-made Qingfu Tongpai Decoction and traditional Chinese medicine nursing based on the routine group after operation. The first exhaust time,first defecation time,gastric tube extubation time,eating time,the incidences and degree of abdominal distension during intervention,the improvement of gastrointestinal function,gastrointestinal function recovery-related complications were compared. Results:The first exhaust time,first defecation time,gastric tube extubation time,eating time of the experimental group were shorter than those of the routine group(P<0.05). The degree of abdominal distention was significantly different between the two groups(P<0.05),and the incidence of abdominal distention in the experimental group was significantly lower than that in the routine group(P<0.05). There was a significant difference in the distribution of nutritional status between the two groups(P<0.05),and the deterioration rate of the experimental group was significantly higher than that of the conventional group(P<0.05). The incidence of adverse gastrointestinal function recovery in the experimental group was significantly lower than that in the conventional group(P<0.05). Conclusion:Self-made Qingfu Tongpai Decoction combined with integrated traditional Chinese and Western medicine on gastrointestinal function after gastric cancer operation can accelerate the recovery of gastrointestinal function,reduce the incidence of abdominal distention and reduce the degree of abdominal distention,improve nutritional status,and reduce gastrointestinal tract dysfunction and adverse events.
Objective:To explore the effect of self-made Qingfu Tongpai Decoction combined with integrated traditional Chinese and Western medicine on gastrointestinal function after gastric cancer operation. Methods:80 cases of postoperative gastric cancer treated in our hospital from March 2016 to March 2018 were divided into two groups by simple randomization. Each includes 40 objects. The routine group was given routine Western medicine and Western medicine nursing after operation,while the experimental group was given self-made Qingfu Tongpai Decoction and traditional Chinese medicine nursing based on the routine group after operation. The first exhaust time,first defecation time,gastric tube extubation time,eating time,the incidences and degree of abdominal distension during intervention,the improvement of gastrointestinal function,gastrointestinal function recovery-related complications were compared. Results:The first exhaust time,first defecation time,gastric tube extubation time,eating time of the experimental group were shorter than those of the routine group(P<0.05). The degree of abdominal distention was significantly different between the two groups(P<0.05),and the incidence of abdominal distention in the experimental group was significantly lower than that in the routine group(P<0.05). There was a significant difference in the distribution of nutritional status between the two groups(P<0.05),and the deterioration rate of the experimental group was significantly higher than that of the conventional group(P<0.05). The incidence of adverse gastrointestinal function recovery in the experimental group was significantly lower than that in the conventional group(P<0.05). Conclusion:Self-made Qingfu Tongpai Decoction combined with integrated traditional Chinese and Western medicine on gastrointestinal function after gastric cancer operation can accelerate the recovery of gastrointestinal function,reduce the incidence of abdominal distention and reduce the degree of abdominal distention,improve nutritional status,and reduce gastrointestinal tract dysfunction and adverse events.
引文
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[22]王新.李培旭主任医师治疗糖尿病肾病经验[D].郑州:河南中医药大学,2016.
[2]王宁.北京地区胃癌发病率、死亡率和生存率[J].癌症康复,2017,33(3):30-31.
[3]任春霞,黄维明.胃癌患者术前营养筛查对其围手术期营养状况及术后恢复的作用[J].肿瘤学杂志,2017,23(5):452-454.
[4]孙琳,王家成,陈珊珊,等.集束化肠内营养护理对改善胃癌患者术后肠内营养耐受性的研究[J].重庆医学,2017,36(3):138-139.
[5]张丰韬,关宁.术后护理干预在促进胃癌根治术胃肠功能康复中的应用[J].实用临床医药杂志,2017,21(12):77-79.
[6]国家重大项目胃癌分子分型与个体化诊疗课题组.胃癌病理分型和诊断标准的建议[J].中华病理学杂志,2010,39(4):266-269.
[7]陈园桃.中医病证诊疗常规[M].南京:东南大学出版社,2008:115-118.
[8]徐勇.理中汤合六君子汤加减治疗胃癌术后胃肠道功能障碍的疗效与安全性[J].重庆医学,2017,36(2):185-187.
[9]王三虎.王三虎诊治胃癌经验[J].四川中医,2017,35(12):202-203.
[10]杨霖,杨国旺,徐咏梅,等.胃癌转移的病机初探[J].北京中医药,2017,36(10):918-920.
[11]陈晓东,潘华峰,蔡甜甜,等.刘友章治疗胃癌前病变临床学术思想探讨[J].中华中医药杂志,2017,10(10):4491-4493.
[12]李星,樊巧玲.胃癌中医辨证与方药应用的文献研究[J].中医杂志,2017,58(8):693-696.
[13]赵颖,王晓炜,陆烨,等.消痰散结方为基础的中药辨证治疗对中晚期胃癌生存质量的影响[J].第二军医大学学报,2016,37(11):1333-1337.
[14]黄立萍,余达,李虹.杨金坤教授治疗胃癌临床经验浅谈[J].浙江中医药大学学报,2017,41(9):747-751.
[15]金玲,叶丽红.叶丽红教授治疗胃癌的临床经验[J].浙江中医药大学学报,2017,41(10):819-822.
[16]孔祥军,岳小强.论“阴虚痰凝毒结”是晚期胃癌的核心病机[J].中医药导报,2017,23(14):56-58.
[17]郭元彪,应海峰,郑岚,等.健脾克癌宁联合四君子汤加减治疗脾气虚型胃癌术后患者疗效及对机体免疫功能的影响[J].现代中西医结合杂志,2017,26(12):1280-1282.
[18]窦云.脾胃虚寒型晚期胃癌行附子理中汤加减联合化疗对外周血T细胞及生活质量影响[J].中国中西医结合消化杂志,2016,24(9):699-702.
[19]王志新,邹玺,胡守友,等.中药抗胃癌的现代药理机制[J].西部中医药,2016,29(4):137-140.
[20]程海波,周仲瑛,沈卫星,等.一种治疗胃癌的中药组合物及其制备方法,CN 104056207 B[P].2017.
[21]张松贞,薛巧云,成淑英.参芪扶正注射液对进展期胃癌患者免疫功能的影响[J].实用临床医药杂志,2016,20(7):48-51.
[22]王新.李培旭主任医师治疗糖尿病肾病经验[D].郑州:河南中医药大学,2016.