子午流注针法对结肠癌术后腹腔热灌注化疗患者胃肠反应影响

【目的】观察子午流注纳子法指导下的辰时电针胃肠下合穴治疗脾胃虚弱型结肠癌术后腹腔热灌注化疗(HIPEC)患者胃肠反应的临床疗效。【方法】将60例符合纳入标准的患者随机分为观察组和对照组,每组各30例。对照组患者术后给予常规治疗和HIPEC治疗,观察组在对照组基础上给予辰时电针胃肠下合穴(足三里、上巨虚、下巨虚)治疗,疗程为5 d。观察2组患者治疗前后Karnofsky功能状态评分(KPS)的变化情况及治疗后患者消化道指标总胆红素(TB)、丙氨酸氨基转氨酶(ALT)、碱性磷酸酶(ALP)]和食欲恢复情况,评价2组患者的胃肠反应和KPS评分的改善疗效。【结果】(1)治疗后,观察组改善恶心呕吐、腹胀腹痛、腹泻等胃肠反应的总有效率分别为83.33%、76.67%、86.67%,对照组分别为50.00%、53.33%、86.67%,观察组改善恶心呕吐、腹胀腹痛的总有效率及总体疗效均明显优于对照组(P<0.05)。(2)治疗后,观察组患者的食欲恢复情况明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,观察组患者的KPS评分较治疗前明显改善(P<0.05),而对照组改善不明显(P>0.05),观察组对KPS评分的改善作用明显优于对照组(P<0.05)。(4)治疗后,观察组患者的KPS评分改善率为56.67%,对照组为23.33%,观察组对KPS评分的改善疗效明显优于对照组(P<0.05)。(5)治疗后,2组患者血清TB、ALT、ALP水平比较,差异均无统计学意义(P>0.05)。【结论】子午流注纳子法指导下的辰时电针胃肠下合穴治疗脾胃虚弱型结肠癌术后HIPEC患者胃肠反应,疗效确切,可明显减轻恶心呕吐、腹胀腹痛发生程度,提高食欲恢复程度,改善KPS评分,从而有利于术后HIPEC患者胃肠功能恢复。

Effect of Ziwu Liuzhu Acupuncture on Gastrointestinal Reaction in Postoperative Colon Cancer Patients After Hyperthermic Intraperitoneal Chemotherapy

Objective To observe the clinical efficacy of Ziwu Liuzhu Nazi acupuncture(a needling method based on acupoint selection according to earthly-branches cycle)on gastrointestinal reaction in postoperative colon cancer patients after hyperthermic intraperitoneal chemotherapy(HIPEC)with spleen-stomach weakness syndrome.Methods Sxity qualified patients were randomly assigned into observation group(n=30)and control group(n=30).The two groups were given conventional postoperative treatment and HIPEC,and additionally,the observation group was given electroacupuncture at gastrointestinal lower he-(sea)points of Zusanli(ST36),Shangjuxu(ST37)and Xiajuxu(ST39)at the time point of Chenshi(at 7∶00-9∶00 in the morning).The treatment lasted 5 days.Before and after treatment,Karnofsky Performance Status(KPS)scores in the two groups were compared.After treatment,gastrointestinal reaction indicators such as total bilirubin(TB),alanine transaminase(ALT)and alkaline phosphatase(ALP)as well as appetite recovery were observed.The efficacy on improving gastrointestinal reaction indicators and KPS scores in the two groups was evaluated at end of the trial.Results(1)After treatment,the total effective rates for nausea and vomiting,abdominal distention and pain,and diarrhea in observation group were 83.33%,76.67%,86.67%respectively,and those in the control group were 50.00%,53.33%,86.67%respectively.The observation group had higher effective rate for nausea and vomiting,abdominal distention and pain,and had stronger overall efficacy than the control group(P<0.05).(2)After treatment,the recovery of appetite in the observation group was superior to that in the control group,and the difference was significant(P<0.05).(3)After treatment,KPS scores in the observation group were much improved(P<0.05 compared with those before treatment),but the improvement of KPS scores in the control group was not obvious(P>0.05).The observation group had stronger effect on improving KPS scores than the control group(P<0.05).(4)After treatment,the improvement rate for KPS scores in the observation group was 56.67%and was higher than that in the control group(23.33%),the difference being significant(P<0.05).(5)After treatment,the differences of serum TB,ALT,and ALP levels between the two groups were insignificant(P>0.05).Conclusion Electroacupuncture at gastrointestinal lower he-(sea)points at the time point of Chenshi(at7∶00-9∶00 in the morning)following the thoughts of Ziwu Liuzhu Nazi acupuncture is effective on improving gastrointestinal reaction in postoperative colon cancer patients after HIPEC with spleen-stomach weakness syndrome.The therapy can obviously reduce nausea and vomiting as well as abdominal distention and pain,and improve appetite recovery and KPS scores,which is helpful for the recovery of gastrointestinal function of postoperative HIPEC patients.