穴位贴敷联合参麦注射液对胃肠道肿瘤患者术后气虚发热及免疫功能的影响  

Effects of acupoint stiking therapy combined with Shenmai injection on Qi-deficiency fever after gastrointestinal tumor operation and its effects on immunologic function

作　　者：张亚丽[1] 尹晓华[1] 于萍[1] 董兴娟 宋易华[1] 

机构地区：[1]河北省中医院外科,河北石家庄050011

出　　处：《河北中医》2016年第11期1640-1644,1651,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2013年度中医药类科研计划课题(编号:2013050)

摘　　要：目的观察穴位贴敷联合参麦注射液对胃肠道肿瘤患者术后气虚发热的影响,并观察对患者术后气虚证候及免疫功能的影响。方法将104例胃肠道肿瘤患者采用随机数字表法分为2组,每组各52例。2组均根据患者病情并结合影像学检查资料制订相应的手术治疗方案,术后常规抗感染、营养、补液治疗。对照组对术后体温在38.5℃以下的发热者予物理降温治疗,38.5℃以上者予注射用赖氨匹林治疗;中医组在对照组治疗基础上术后加穴位贴敷联合参麦注射液干预治疗。2组均治疗7 d,观察比较2组术后出现发热例数、发热时体温及发热持续时间,比较2组治疗前后气虚证候积分改善情况,比较2组术前及术后第1、7 d T淋巴细胞亚群细胞CD^(3+)、CD^(4+)、CD^(4+)/CD^(8+)及免疫球蛋白G(Ig G)、Ig A、Ig M水平变化。结果 2组术后出现发热例数及发热持续时间、发热时体温比较差异均有统计学意义(P<0.05),治疗组出现发热例数少于对照组,发热时体温低于对照组,发热持续时间短于对照组。2组治疗后气虚证候气短、神疲、乏力、自汗及懒言积分与本组治疗前比较均明显降低,且中医组低于对照组,比较差异均有统计学意义(P<0.05)。2组术后第1 d T淋巴细胞亚群细胞CD^(3+)、CD^(4+)、CD^(4+)/CD^(8+)及Ig G、Ig A、Ig M水平较术前均明显下降,比较差异有统计学意义(P<0.05),且2组水平相当(P>0.05);2组术后第7 d T淋巴细胞亚群CD^(3+)、CD^(4+)、CD^(4+)/CD^(8+)及Ig G、Ig A、Ig M水平较术后第1 d均上升,且中医组高于对照组,比较差异有统计学意义(P<0.05)。结论穴位贴敷联合参麦注射液治疗胃肠道肿瘤术后气虚发热疗效确切,可以明显改善患者术后气虚证候,预防发热的发生,降低发热温度,缩短发热持续时间,促进患者T淋巴细胞亚群及免疫球蛋白水平恢复,提高患者机体免疫功能。Objective To observe the effects of acupoint stiking therapy combined with Shenmai injection on Qi - deficiency fever after gastrointestinal tumor operation, and its effects on postoperative Qi - deficiency syndrome and immunologic function. Methods 104 with gastrointestinal tumor were randomly divided in to two groups, 52 in each group. The operation plan was desired according to personal condition and imaging data in two groups. Postoper-atively, routine treatment of anti - infenction, extra - nutriton and fluid infusion were conducted. The control group re-ceived physical cooling when patients^temperature was under the 38. 5 after operation, and received Aspirin - D L -Lysine for injection when temperature was above 38.5 , and the Traditional Chinese medicine （TCM） group re-ceived acupoint stiking therapy combined with Shenmai injection on the basis of control group treatment, continuouslytreatment for 7 d. The fever cases load, fever temperature and duration of fever after operation were observed in two groups. The scores of Qi - deficiency syndrome before and after treatment were compared. The T lymphocyte subgroup （ CD3 ＋, CD4 ＋, CD4 ＋ /CD8 ＋ ） , immunoglobulin - G （IgG） , IgA and IgM before and 1, 7 d after operation were compared. Results The fever cases load, the fever temper-ature and duration of fever after operation in treatment group were fewer than those in control group, with statistical differ-ences （P 〈 0. 05 ） . The scores of shortness of breath, fatigue, weak, spontaneous sweating and laziness to speak after treatment were obvious decreased in two groups, and scores after treatment in TCM group was lower than control group, with statistical differences （ P 〈 0. 05 ） . The T lym-phocyte subgroup （ CD3 ＋ , CD4＋,CD4 ＋ /C D 8 ＋ ） , IgG, IgA and IgM one day after operation were obvious de-creased as compared with before treatment in two groups, with statistical differences （P 〈0.

关 键 词：胃肠肿瘤 手术后期间 发热 气虚 穴位贴敷法 麦冬 人参 注射剂 

分 类 号：R735.5[医药卫生—肿瘤] R241.8[医药卫生—临床医学]