穴位按摩联合热敏灸缓解肝癌术后患者气滞型呃逆的效果观察
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摘要
目的探讨穴位按摩联合热敏灸对肝癌术后气滞型呃逆患者呃逆缓解有效率及缓解时间的影响。方法抽取2014年1月—2018年1月本院肝胆胰外科病房因肝癌行腹腔镜或开腹手术术后2 h麻醉清醒后出现呃逆,经常规处理1 h无效的患者作为研究对象。采用简单随机数字表法分为对照组(n=23)及观察组(n=25),对照组在穴位按摩基础上予盐酸甲氧氯普胺注射液10 mg肌内注射,观察组予穴位按摩联合热敏灸,1次/d,3 d为1个疗程,干预1个疗程。观察2组患者干预3 d末呃逆缓解有效率、呃逆缓解起效时间及起效后4 h内呃逆复发率。结果干预3 d末,观察组肝癌术后气滞型呃逆患者呃逆缓解有效率为92%,对照组为70%,差异有统计学意义(χ~2=6.873,P<0.05);对照组干预后呃逆症状缓解起效时间为90(60,120)min;起效后4 h内呃逆复发率为69%,观察组干预后呃逆症状缓解起效时间为30(22,35)min,起效后4 h内呃逆复发率为17%,2组间比较,差异均有统计学意义(P<0.05)。结论穴位按摩联合热敏灸可有效缓解肝癌术后患者气滞型呃逆,缩短症状缓解的起效时间及起效后4 h内呃逆复发率。
Objective To explore the effective rate and remission time of acupoint massage combined with heat-sensitive moxibustion in treating Qi-stagnation-type hiccup in patients after surgery for hepatocellular carcinoma. Methods From January2014 to January 2018, in department of hepatopancreatobiliary surgery, 48 patients had hiccups after the surgery for hepatocellular carcinoma and could not be alleviated by routine treatment were randomly assigned to the control group(n=23) and the observation group(n=25). The observation group was treated with acupoint massage combined with heat-sensitive moxibustion once a day, three days as a course of treatment and the control group with acupoint massage and 10 mg metoclopramide hydrochloride intramuscular injection.After one course of treatment, the effective rate of relieving hiccups, onset time and 4-hour recurrence rate were compared between the two groups. Results The effective rate was 92% in the observation group and 70% in the control group(χ~2=6.873, P<0.05).The onset time of relieving hiccup was 90(60,120) minutes in the control group and 30(22,35) minutes in the observation group and the 4-hour recurrence rate was 69% and 17% respectively. All the differences had statistical significance(P<0.05). Conclusion Acupoint massage combined with heat-sensitive moxibustion can effectively alleviate the Qi-stagnation-type hiccup after the surgery for hepatocellular carcinoma with short onset time and lower recurrence rate in 4 hours.
Objective To explore the effective rate and remission time of acupoint massage combined with heat-sensitive moxibustion in treating Qi-stagnation-type hiccup in patients after surgery for hepatocellular carcinoma. Methods From January2014 to January 2018, in department of hepatopancreatobiliary surgery, 48 patients had hiccups after the surgery for hepatocellular carcinoma and could not be alleviated by routine treatment were randomly assigned to the control group(n=23) and the observation group(n=25). The observation group was treated with acupoint massage combined with heat-sensitive moxibustion once a day, three days as a course of treatment and the control group with acupoint massage and 10 mg metoclopramide hydrochloride intramuscular injection.After one course of treatment, the effective rate of relieving hiccups, onset time and 4-hour recurrence rate were compared between the two groups. Results The effective rate was 92% in the observation group and 70% in the control group(χ~2=6.873, P<0.05).The onset time of relieving hiccup was 90(60,120) minutes in the control group and 30(22,35) minutes in the observation group and the 4-hour recurrence rate was 69% and 17% respectively. All the differences had statistical significance(P<0.05). Conclusion Acupoint massage combined with heat-sensitive moxibustion can effectively alleviate the Qi-stagnation-type hiccup after the surgery for hepatocellular carcinoma with short onset time and lower recurrence rate in 4 hours.
引文
[1]张世科,高维滨,刘勇,等.电针颈夹脊穴治疗肝癌切除术后顽固性呃逆的疗效观察[J].中华肿瘤杂志,2018,40(2):138-140.DOI:10.3760/cma.j.issn.0253-3766.2018.02.011.
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[6]李文娟,吕凤兰,吴洁兰,等.穴位按摩在肝癌顽固性呃逆的疗效观察[J].云南中医中药杂志,2014,35(6):102.DOI:1007-2349(2014)06-0102-01.
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[10]陈日新,康明非,陈明人.《内经》腧穴概念在热敏灸中的重要指导作用[J].江西中医学院学报,2010,22(3):36-38.
[11]中华人民共和国卫生部.原发性肝癌诊疗规范(2011年版)摘要[J].中华肝脏病杂志,2012,20(6):412-419.
[12]王芳.辨证运用水针治疗顽固性呃逆疗效观察[J].中医药临床杂志志,2010,22(7):591-592.DOI:10.16448/j.cjtcm.2010.07.018.
[13]国家技术监督局.GB/T 12346-2006.中华人民共和国国家标准经穴部位[S].北京:中国标准出版社,2006.
[14]梅怡明,刘杏仙,王恒,等.艾灸天突穴治疗腹部手术后呃逆疗效观察[J].浙江中西医结合杂志,2006,16(11):713.
[15]姚丽芬.艾灸治疗顽固性呃逆30例[J].四川中医,2007,25(9):110-110.DOI:1000-3649{2007)09-0110-01.
[16]吴颖,热西代·多里坤,刘智艳.热敏灸疗法的临床研究进展[J].新疆中医药,2018,36(2):106-107.
[17]中华医学会.临床诊疗指南[M].北京:人民卫生出版社,2006:6.
[2]Seker,M M,Aksoy,S,Ozdemir,N Y.Successful Treatment of Chronic Hiccup with Baclofen in Cancer Patients[J].Med Oncol,2012,29(2):1369-1370.DOI:10.1007/S12032-011-9910-3.
[3]Arsanious D,khoury S,Martinez E,et al.Ultrasound-guided Phrenic Nerve Block for Intractable Hiccups Following Placement of Esophageal Stent for Esophageal Squamous Cell Carcinoma[J].Pain Physician,2016,19(4):653-656.
[4]章国英,苏琴.穴位经皮电刺激联合利他林注射治疗脑卒中后顽固性呃逆的效果观察[J].护理学报,2015,22(14):66-67.DOI:10.16460/j.issn1008-9969.2015.14.066.
[5]任琳,任学芳.中枢性顽固性呃逆的治疗与护理干预进展[J].护理学报,2016,23(9):26-29.DOI:10.16460/j.issn1008-9969.2016.09.026.
[6]李文娟,吕凤兰,吴洁兰,等.穴位按摩在肝癌顽固性呃逆的疗效观察[J].云南中医中药杂志,2014,35(6):102.DOI:1007-2349(2014)06-0102-01.
[7]李琛,王小萌.灸法治疗寒凝气滞型顽固性呃逆64例[J].陕西中医,2012,33(6):725-726.DOI:1000-7369(2012)06-0725-02.
[8]孙立新,李鴳.艾灸配合推拿治疗顽固性呃逆36例[J].中医临床研究,2014,9(1):34-35.DOI:10.3969/j.issn1674-7860.2014.10.017.
[9]陈志强,谭志健,蔡炳勤.外科学术经验集[M].北京:中国中医药出版社,2013:95.
[10]陈日新,康明非,陈明人.《内经》腧穴概念在热敏灸中的重要指导作用[J].江西中医学院学报,2010,22(3):36-38.
[11]中华人民共和国卫生部.原发性肝癌诊疗规范(2011年版)摘要[J].中华肝脏病杂志,2012,20(6):412-419.
[12]王芳.辨证运用水针治疗顽固性呃逆疗效观察[J].中医药临床杂志志,2010,22(7):591-592.DOI:10.16448/j.cjtcm.2010.07.018.
[13]国家技术监督局.GB/T 12346-2006.中华人民共和国国家标准经穴部位[S].北京:中国标准出版社,2006.
[14]梅怡明,刘杏仙,王恒,等.艾灸天突穴治疗腹部手术后呃逆疗效观察[J].浙江中西医结合杂志,2006,16(11):713.
[15]姚丽芬.艾灸治疗顽固性呃逆30例[J].四川中医,2007,25(9):110-110.DOI:1000-3649{2007)09-0110-01.
[16]吴颖,热西代·多里坤,刘智艳.热敏灸疗法的临床研究进展[J].新疆中医药,2018,36(2):106-107.
[17]中华医学会.临床诊疗指南[M].北京:人民卫生出版社,2006:6.