马齿苋汤保留灌肠配合内服中药对大肠侧向发育型肿瘤ESD术后创面愈合的影响
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摘要
目的探讨大肠侧向发育型肿瘤(LST)于内镜黏膜下剥离术(ESD)后使用中药处理,对防止并发症及创面愈合的效果。方法对94例基底部直径2~3.5 mm的LST行ESD治疗,于术后禁食,卧床休息,密切观察病情变化,注意是否发生腹痛、便血等不良反应。其中52例作为试验组给予中药口服及灌肠治疗,42例作为对照组。评价2组疗效标准。结果第1周,试验组痊愈率28.85%,总愈合率61.54%,高于对照组的7.14%和35.71%(P<0.05);第2周,试验组痊愈率64.46%高于对照组的42.86%(P<0.05);第3周,试验组痊愈率86.54%,总愈合率100%,明显高于对照组的57.14%和90.48%(P<0.05)。结论该中药疗法对ESD术后溃疡愈合具有一定促进作用,可作为大肠ESD术后常规治疗手段。
Objective To investigate the effect of treatment of late-stage spreading tumor(LST) after endoscopic submucosal dissection(ESD) on the prevention of complications and wound healing. Methods 94 patients with largebowel lateralized tumors of 2 mm to 3.5 mm in diameter were subjected to ESD treatment. The patients were fasted, rested in bed, observed the changes of the disease and observed whether abdominal pain or hematochezia occurred. Among them, 52 cases were treated by oral and enema with Chinese medicine as experimental group, taking 42 cases as control group. Results In the first week, the cure rate in the test group was 28.85% and the total healing rate was 61.54%, which was higher than that in the control group(7.14%) and 35.71%(P < 0.05). The cure rate in the trial group was 64.46%, which was higher than that in the control group(42.86%, P < 0.05). In the third week, the healing rate of the experimental group was 86.54%, the total healing rate was 100%, which was significantly higher than the control group(57.14%, 90.48%)(P < 0.05). Conclusion this traditional Chinese medicine therapy can promote the healing of ulcer after ESD, and it can be used as routine treatment for large intestine after ESD.
Objective To investigate the effect of treatment of late-stage spreading tumor(LST) after endoscopic submucosal dissection(ESD) on the prevention of complications and wound healing. Methods 94 patients with largebowel lateralized tumors of 2 mm to 3.5 mm in diameter were subjected to ESD treatment. The patients were fasted, rested in bed, observed the changes of the disease and observed whether abdominal pain or hematochezia occurred. Among them, 52 cases were treated by oral and enema with Chinese medicine as experimental group, taking 42 cases as control group. Results In the first week, the cure rate in the test group was 28.85% and the total healing rate was 61.54%, which was higher than that in the control group(7.14%) and 35.71%(P < 0.05). The cure rate in the trial group was 64.46%, which was higher than that in the control group(42.86%, P < 0.05). In the third week, the healing rate of the experimental group was 86.54%, the total healing rate was 100%, which was significantly higher than the control group(57.14%, 90.48%)(P < 0.05). Conclusion this traditional Chinese medicine therapy can promote the healing of ulcer after ESD, and it can be used as routine treatment for large intestine after ESD.
引文
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[12]王庆国,李宇航,牛欣,等.半夏泻心汤及其拆方对慢性胃溃疡大鼠表皮生长因子的影响[J].中国中西医结合急救杂志,2001,8(3):137-139.
[13]王帅,翟军鹏,周滔,等.三黄汤灌肠对实验性溃疡性结肠炎结肠组织白细胞介素-1β的影响[J].北京中医药,2010,29(12):950-952.
[14]何亚琴,何群峰,赵虞文,等.肠宁方灌肠联合美沙拉嗪对溃疡性直肠炎患者炎症因子及凝血功能的影响[J].中国临床药理学与治疗学,2017,22(7):805-809.
[15]谢海芳,詹雅珍.肠宁方灌肠联合美沙拉嗪对溃疡性直肠炎患者炎症因子及凝血功能的影响[J].世界华人消化杂志,2017,25(19):1793-1797.
[16]许晓蓓,王威,李瑞根,等.中医药治疗胃黏膜损伤研究概况[J].实用中医内科杂志,2017,31(2):79-82.
[17]涂小华,李茹柳,邓娇,等.四君子汤多糖对小肠上皮细胞迁移多胺信号通路钙离子调控的影响[J].中华中医药杂志,2016,31(5):1665-1673.
[2]HASHIMOTO T,ADACHI K.Changes in gastric mucosal blood flow during healing of EMR-Induced ulcer[J].Digestive Endoscopy,1997,9(2):127-131.
[3]胡倩,罗怀岗,李五生.中药灌肠对溃疡性结肠炎的治疗进展[J].临床合理用药杂志,2016,9(4):167-168.
[4]ODA I,GOTODA T,HAMANAKA H,et al.Endoscopic submucosal dissection for early gastric cancer:technical feasibility,operation time and complications from a large consecutive series[J].Digestive Endoscopy,2005,17(1):54-58.
[5]KIM JW K H,:1610-1616 E A.Risk factors for delayed postendoscopic mucosal resection hemorrhage in patients with gastric tumor[J].European Journal of Gastroenterology&Hepatology,2007,19(5):409-415.
[6]张月明,王贵齐.内镜粘膜切除及粘膜下剥离术的并发症处理及预防[J].中华内镜杂志,2008,25(11):567-569.
[7]Uedo N,Takeuchi Y,Yamada T,et al.Effect of a proton pump inhibitor or an H2-receptor antagonist on prevention of bleeding from ulcer after endoscopic submucosal dissection of early gastric cancer:a prospective randomized controlled trial[J].American Journal of Gastroenterology,2007,102(8):1610-1616.
[8]叶任高.内科学[M].5版.北京:人民卫生出版社,2002:398.
[9]JOHNSON L R,GUTHRIE P D.Stimulation of rat oxyntic gland mucosal growth by epidermal growth factor[J].The American Journal of Physiology,1980,238(1):G45-G49.
[10]于正龙,沈炳棣.表皮生长因子治疗消化性溃疡的研究[J].中华消化杂志,1994,14(2):119-120.
[11]ITOH M,JOH T,IMAI S,et al.Experimental and clinical studies on epidermal growth factor for gastric mucosal protection and healing of gastric ulcers[J].Journal of Clinical Gastroenterology,1988,10(Suppl 1):S7-12.
[12]王庆国,李宇航,牛欣,等.半夏泻心汤及其拆方对慢性胃溃疡大鼠表皮生长因子的影响[J].中国中西医结合急救杂志,2001,8(3):137-139.
[13]王帅,翟军鹏,周滔,等.三黄汤灌肠对实验性溃疡性结肠炎结肠组织白细胞介素-1β的影响[J].北京中医药,2010,29(12):950-952.
[14]何亚琴,何群峰,赵虞文,等.肠宁方灌肠联合美沙拉嗪对溃疡性直肠炎患者炎症因子及凝血功能的影响[J].中国临床药理学与治疗学,2017,22(7):805-809.
[15]谢海芳,詹雅珍.肠宁方灌肠联合美沙拉嗪对溃疡性直肠炎患者炎症因子及凝血功能的影响[J].世界华人消化杂志,2017,25(19):1793-1797.
[16]许晓蓓,王威,李瑞根,等.中医药治疗胃黏膜损伤研究概况[J].实用中医内科杂志,2017,31(2):79-82.
[17]涂小华,李茹柳,邓娇,等.四君子汤多糖对小肠上皮细胞迁移多胺信号通路钙离子调控的影响[J].中华中医药杂志,2016,31(5):1665-1673.