小麦纤维素颗粒治疗直肠癌术后排便功能紊乱及调节脂质代谢的临床效果观察  

Clinical effect of wheat cellulose granules on defecation dysfunction and lipid metabolism in patients after rectal cancer operation

作　　者：陈丹[1] 胡丰良[1] 魏保沛 孙锋[1] 罗维民[1] 李洪杰[1] 

机构地区：[1]广州中医药大学第一附属医院肛肠科,510405

出　　处：《中国医药》2017年第4期562-565,共4页China Medicine

摘　　要：目的观察小麦纤维素颗粒治疗直肠癌术后排便功能紊乱及调节脂质代谢的临床效果及安全性。方法选取于2014年3—10月在广州中医药大学第一附属医院行直肠癌保肛手术的住院患者30例。所有患者自直肠癌术后胃肠功能恢复进普食起，即给予小麦纤维素颗粒（非比麸）口服，3.5 g/次，2次/d，连续用药2周。观察用药前后的排便情况、脂质代谢水平、药物疗效、不良反应以及医患双方满意度，并进行量化比较。结果用药后患者的大便频率、排便紧迫感、肛门坠胀及疼痛感、肛周皮肤刺激感症状评分与用药前比较均明显降低［（0.8±0.6）分比（2.2±1.0）分，（0.50±0.40）分比（1.80±0.10）分，（0.5±0.4）分比（1.6±0.8）分，（0.25±0.07）分比（0.57±0.23）分］，差异均有统计学意义（均P＜0.05）。服药前患者的大便性状Bristol分型为1型1例（3.3%），2型2例（6.7%），3型3例（10.0%），6型17例（56.7%），7型7例（23.3%）；用药后为4型12例（40.0%），5型16例（53.3%），6型2例（6.7%），较用药前有所改善。用药后患者血清总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆汁酸出现异常的比例均较用药前降低。经治疗后显效患者19例（63.3%），有效患者7例（23.3%）；总有效率为86.7%（26/30）。所有患者用药期间均未发生不良反应。医患双方的满意度均较高，医师结果为非常满意16例（53.3%），比较满意7例（23.3%）；患者结果为非常满意17例（56.7%），比较满意8例（26.7%）。结论小麦纤维素颗粒可有效地改善直肠癌术后排便功能紊乱及调节脂质代谢，安全有效，满意度高。ObjectiveTo observe efficacy and safety of wheat cellulose granules in treating defecation dysfunction and regulating lipid metabolism after rectal cancer operation. MethodsA total of 30 patients with rectal cancer who had sphincter-preserving operation were enrolled in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from March 2014 to October 2014. All patients had wheat cellulose granules（fiberform） since gastrointestinal function recovered after operation, 3.5 g 2 times/d, 2 weeks. Defecation, lipid metabolism, efficacy of medication, adverse reactions and doctor-patient satisfaction were analyzed. ResultsScores of defecation frequency, urgent sense of defecation, anal downbearing distention and pain, perianal skin irritation after drug use were significantly decreased compared to those before drug use[（0.8±0.6）scores vs （2.2±1.0）scores, （0.50±0.40）scores vs （1.80±0.10）scores, （0.5±0.4）scores vs （1.6±0.8）scores, （0.25±0.07）scores vs （0.57±0.23）scores]（P〈0.05）. Defecate characters classified by Bristol scale before drug use included 1 case（3.3%） of grade 1, 2 cases（6.7%） of grade 2, 3 cases（10.0%） of grade 3, 17 cases（56.7%） of grade 6 and 7 cases（23.3%） of grade 7; defecate characters after drug use included 12 cases（40.0%） of grade 4, 16 cases（53.3%） of grade 4 and 2 cases（6.7%） of grade 6. Proportions of patients with abnormal serum total cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and total bile acid after drug use were decreased. After treatment, 19 cases（63.3%） had significant effect and 7 cases（23.3%） were effective; the total effective rate was 86.7%（26/30）. No severe adverse reaction was observed. Both doctor and patient satisfactions were good. ConclusionsWheat cellulose granules is safe and effective in treating defecation dysfunction and regulating lipid metabolism after rectal cancer operation.

关 键 词：直肠肿瘤 小麦纤维素 排便 脂质代谢 

分 类 号：R735.3[医药卫生—肿瘤]