调肝理脾和胃汤联合针灸治疗消化道肿瘤术后胃瘫综合征临床观察
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摘要
目的研究调肝理脾和胃汤联合针灸治疗消化道肿瘤术后胃瘫综合征(PGS)的疗效。方法于2016年1月—2017年6月期间随机选取医院收治PGS患者78例,按随机数表法分为2组。对照组给予常规治疗并服用多潘立酮,3次/天,服用4周;同时服用调肝理脾和胃方,分3次服用,1剂/天,服用4周;观察组在对照组基础上给予针灸辅助治疗,1次/天,治疗4周。统计两组患者疗效;采用胃瘫症状严重指数(GCSI)评估患者治疗前后GS严重程度,采用匹茨堡睡眠质量指数(PSQI)评估患者治疗前后睡眠质量;统计治疗前后两组患者胃全排空时间,检测患者治疗前后胃动素、胃泌素水平;检测两组患者治疗前后血清生长抑素、血管活性肠肽、白介素-6(IL-6)、白介素-10(IL-10)水平;统计两组患者治疗前后心率,收缩压,舒张压水平;统计两组患者不良反应发生率。结果观察组治疗有效率(95. 24%)高于对照组(75. 00%)(P <0. 05);治疗后,观察组GCSI指数、PSQI分数均低于对照组(P <0. 05);治疗后,观察组胃动素、胃泌素水平均高于对照组,胃全排空时间低于对照组(P <0. 05);治疗后,观察组血清生长抑素、血管活性肠肽、IL-6水平均低于对照组,IL-10水平高于对照组(P <0. 05);两组患者均未出现严重不良反应。结论调肝理脾和胃汤联合针灸治疗消化道肿瘤术后PGS疗效较好。
Objective To study the efficacy of Tiaogan Lipi Hewei decoction combined with acupuncture and moxibustion in the treatment of gastroparesis syndrome( PGS) after digestive tract tumor surgery. Methods A total of 78 patients with PGS who were treated in the hospital from January 2016 to June 2017 were randomly divided into two groups according to the random number table method. The control group was given routine treatment and administered with domperidone with 3 times/d for 4 weeks,and Tiaogan Lipi Hewei decoction 1 dose/d for 3 times for 4 weeks. The observation group was given acupuncture and moxibustion adjuvant therapy with once a day for 4 weeks on the basis of treatment for the control group. The pre-and post-treatment severity of GS was assessed using gastroparesis syndrome severity index( GCSI) and the quality of sleep was assessed using the Pittsburgh Sleep Quality Index( PSQI) The gastric complete emptying time in the two groups was recorded. The levels of motilin,gastrin,serum somatostatin,vasoactive intestinal peptide,interleukin-6( IL-6) and interleukin-10( IL-10) were measured in the two groups before and after treatment. Heart rate,systolic blood pressure and diastolic blood pressure were measured in the two groups before and after treatment. The incidence rate of adverse reactions in the two groups was calculated. Results The effective rate of treatment in the observation group was higher than that in the control group(95. 24% vs. 75. 00%; P < 0. 05). After treatment,the GCSI index and PSQI score in the observation group were significantly lowered than those in the control group(P < 0. 05). After treatment,the levels of motilin and gastrin in the observation group were higher than those in the control group,and the gastric complete emptying time was lower than that in the control group(P < 0. 05). After treatment,the serum levels of somatostatin,vasoactive intestinal peptide and IL-6 in the observation group were lower than those in the control group while the IL-10 level was higher than that in the control group(P <0. 05). There was no serious adverse reactions in the two group. Conclusion Tiaogan Lipi Hewei decoction combined with external application with traditional Chinese medicine has good efficacy in treating PGS digestive tract tumor surgery.
Objective To study the efficacy of Tiaogan Lipi Hewei decoction combined with acupuncture and moxibustion in the treatment of gastroparesis syndrome( PGS) after digestive tract tumor surgery. Methods A total of 78 patients with PGS who were treated in the hospital from January 2016 to June 2017 were randomly divided into two groups according to the random number table method. The control group was given routine treatment and administered with domperidone with 3 times/d for 4 weeks,and Tiaogan Lipi Hewei decoction 1 dose/d for 3 times for 4 weeks. The observation group was given acupuncture and moxibustion adjuvant therapy with once a day for 4 weeks on the basis of treatment for the control group. The pre-and post-treatment severity of GS was assessed using gastroparesis syndrome severity index( GCSI) and the quality of sleep was assessed using the Pittsburgh Sleep Quality Index( PSQI) The gastric complete emptying time in the two groups was recorded. The levels of motilin,gastrin,serum somatostatin,vasoactive intestinal peptide,interleukin-6( IL-6) and interleukin-10( IL-10) were measured in the two groups before and after treatment. Heart rate,systolic blood pressure and diastolic blood pressure were measured in the two groups before and after treatment. The incidence rate of adverse reactions in the two groups was calculated. Results The effective rate of treatment in the observation group was higher than that in the control group(95. 24% vs. 75. 00%; P < 0. 05). After treatment,the GCSI index and PSQI score in the observation group were significantly lowered than those in the control group(P < 0. 05). After treatment,the levels of motilin and gastrin in the observation group were higher than those in the control group,and the gastric complete emptying time was lower than that in the control group(P < 0. 05). After treatment,the serum levels of somatostatin,vasoactive intestinal peptide and IL-6 in the observation group were lower than those in the control group while the IL-10 level was higher than that in the control group(P <0. 05). There was no serious adverse reactions in the two group. Conclusion Tiaogan Lipi Hewei decoction combined with external application with traditional Chinese medicine has good efficacy in treating PGS digestive tract tumor surgery.
引文
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[7]黄烈弥,喻佳丽,杨秋萍.干扰电联合特定电磁波治疗腹部手术后胃瘫综合征[J].中华物理医学与康复杂志,2014,36(7):562-563.
[8]李艳,范晓萍,郭雄波,等.穴位注射治疗胃手术后胃瘫综合征疗效观察[J].中国全科医学,2014,17(1):113-114.
[9]田桢,李泉旺,肖俐,等.针刺联合穴位贴敷治疗消化道恶性肿瘤术后胃瘫综合征[J].中医学报,2018,33(6):953-957.
[10]董万斌,闰玉洁,赵增喜,等.温针灸联合肠内营养治疗术后胃瘫综合征的临床疗效观察[J].环球中医药,2017,10(9):1034-1036.
[2]陈宏刚,陈勇,易深根,等.大肠癌根治术后胃瘫综合征的临床分析[J].中国普通外科杂志,2016,25(4):510-517.
[3]李涛,王福顺,朱继业,等.胰十二指肠切除术后胃瘫的诊断和治疗[J].中华实验外科杂志,2016,33(3):778-780.
[4]秦新裕,刘凤林.术后胃瘫的诊断与治疗[J].中华消化杂志,2005,25(7):441-442.
[5]郑晓萸.中药新药临床研究[M].北京:中国医药科技出版社,2002:134-135.
[6]刘淑刚.乌梅丸(汤)加减治疗术后胃瘫综合征[J].中国中医基础医学杂志,2015,21(4):475-476.
[7]黄烈弥,喻佳丽,杨秋萍.干扰电联合特定电磁波治疗腹部手术后胃瘫综合征[J].中华物理医学与康复杂志,2014,36(7):562-563.
[8]李艳,范晓萍,郭雄波,等.穴位注射治疗胃手术后胃瘫综合征疗效观察[J].中国全科医学,2014,17(1):113-114.
[9]田桢,李泉旺,肖俐,等.针刺联合穴位贴敷治疗消化道恶性肿瘤术后胃瘫综合征[J].中医学报,2018,33(6):953-957.
[10]董万斌,闰玉洁,赵增喜,等.温针灸联合肠内营养治疗术后胃瘫综合征的临床疗效观察[J].环球中医药,2017,10(9):1034-1036.