健脾止泻汤联合针灸对结肠癌术后急性腹泻患者胃肠功能和胃肠激素的影响

目的:观察健脾止泻汤联合针灸对结肠癌术后急性腹泻患者胃肠功能和胃肠激素的影响。方法:将104例结肠癌术后急性腹泻患者按随机数字表法均分为两组。两组均在结肠癌根治术后采用XELOX方案化疗,对照组给予盐酸洛哌丁胺胶囊治疗,观察组在对照组基础上给予健脾止泻汤联合针灸治疗。比较两组胃肠激素、肠黏膜屏障功能、中医证候积分、Karnofsky评分的变化,记录两组粪便性状恢复正常时间、症状消失时间、疗效和安全性。结果:两组治疗后胃泌素(GAS)、胃动素(MTL)、内毒素、二胺氧化酶(DAO)、D乳酸指标低于治疗前,抑胃肽(GIP)指标高于治疗前(P<0.05),观察组GAS、MTL、内毒素、DAO、D乳酸明显低于对照组,GIP指标明显高于对照组(P<0.05)。两组治疗后中医证候积分均低于治疗前,KPS评分均高于治疗前,但观察组中医证候积分显著低于对照组,KPS评分显著高于对照组(P<0.05)。观察组粪便性状恢复正常时间和腹痛、腹泻消失时间均短于对照组,治疗总有效率为90.38%,高于对照组(P<0.05)。观察组不良反应率与对照组比较,差异无统计学意义(P>0.05)。结论:健脾止泻汤联合针灸治疗结肠癌术后急性腹泻可改善胃肠激素,减轻肠黏膜屏障的损害,且安全性好。

Effects of Jianpi Zhixie decoction combined with acupuncture on gastrointestinal function and gastrointestinal hormones in patients with acute diarrhea after colon cancer operation

Objective:To study the effects of Jianpi Zhixie decoction combined with acupuncture and moxibustion on gastrointestinal function and gastrointestinal hormones in patients with acute diarrhea after colon cancer operation.Methods:104 patients with acute diarrhea after colon cancer surgery were divided into two groups by random number table method.Both groups were treated with XELOX chemotherapy after radical operation for colon cancer,the control group was treated with loperamide hydrochloride capsules,and the observation group was treated with Jianpi Zhixie decoction combined with acupuncture and moxibustion on the basis of the control group.The changes of gastrointestinal hormones,intestinal mucosal barrier function,TCM syndrome score,and Karnofsky score were compared between the two groups,and the time for feces to return to normal,the time for symptom disappearance,and the efficacy and safety were recorded in the two groups.Results:After treatment,the indexes of GAS,MTL,endotoxin,DAO and D-lactate in the two groups were lower than those before treatment,and the indexes of GIP were higher than those before treatment(P<0.05),and the GAS,MTL,endotoxin,DAO,D lactate and other indicators in the observation group were significantly lower than those in the control group,and the GIP indicators were significantly higher than control group(P<0.05).The scores of TCM syndromes in the two groups were lower than before treatment,and the KPS score was higher than before treatment,and the scores of TCM syndromes in the observation group were significantly lower than control group,and the KPS scores were significantly higher than control group(P<0.05).The time to return to normal feces and the disappearance time of abdominal pain and diarrhea in the observation group were shorter than control group,and the total effective rate was 90.38%,which was higher than that in control group(P<0.05).There was no statistical significance in the adverse reaction rate compared with the control group(P>0.05).Conclusion:Jianpi Zhixie decoction combined with acupuncture in the treatment of postoperative acute diarrhea of colon cancer can improve gastrointestinal hormones and reduce the damage of intestinal mucosal barrier.