雷火灸对脾胃虚寒型胃癌术后腹腔热灌注化疗患者胃肠功能恢复的疗效观察  

Clinical Observation on Thunder-Fire Moxibustion for Recovery of Gastrointestinal Function in Spleen-Stomach Deficiency-Cold Type of Patients Receiving Hyperthermic Intraperitoneal Chemotherapy after Gastric Cancer Surgery

作　　者：李小华[1] 王玉汶 许志恒[3] 陈镇瑶 陈琦[1] 陈育忠[3] LI Xiao-Hua;WANG Yu-Wen;XU Zhi-Heng;CHEN Zhen-Yao;CHEN Qi;CHEN Yu-Zhong(Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510095 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]广东省第二中医院,广东广州510095 [3]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2021年第3期531-538,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局基金项目(编号:20171089)。

摘　　要：【目的】观察雷火灸对脾胃虚寒型胃癌术后腹腔热灌注化疗(HIPEC)患者胃肠功能恢复的临床疗效,并探讨其可能的作用机制。【方法】将60例脾胃虚寒型胃癌术后HIPEC患者随机分为治疗组和对照组,每组各30例。对照组给予胃癌术后常规治疗及HIPEC治疗。治疗组在对照组治疗的基础上,在HIPEC治疗后2 h给予穴位(双侧足三里、上巨虚、下巨虚)雷火灸干预,治疗时间为20 min,每天1次,连续治疗7 d。观察2组患者恶心、呕吐、腹胀、腹泻胃肠反应分度评估的情况,并评价其临床疗效;比较2组患者首次肠鸣音、肛门排气、排便时间的情况,分别于术后第1、3、7天,观察2组患者血液中白细胞(WBC)计数、中性粒细胞(N)计数、C反应蛋白(CRP)及白细胞介素6(IL-6)含量的变化情况。分别记录2组患者住院的总天数,并进行比较。【结果】(1)2组患者恶心临床疗效比较:治疗组总有效率为90.00%(27/30),对照组为76.67%(23/30),治疗组疗效优于对照组,差异有统计学意义(P<0.05)。2组患者呕吐临床疗效比较:治疗组总有效率为93.33%(28/30),对照组为76.67%(23/30),治疗组疗效优于对照组,差异有统计学意义(P<0.05)。2组患者腹胀临床疗效比较:治疗组总有效率为80.00%(24/30),对照组为63.33%(19/30),治疗组疗效优于对照组,差异有统计学意义(P<0.05)。2组患者腹泻临床疗效比较:治疗组总有效率为83.33%(25/30),对照组为66.67%(20/30),治疗组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,治疗组首次肠鸣音、肛门排气与排便时间均明显缩短,与对照组比较,差异有统计学意义(P<0.05)。(3)经过治疗后,于术后第3、7天,治疗组患者的WBC、N与IL-6水平均较同组术后第1天明显改善,差异有统计学意义(P<0.05);术后第3天,对照组患者的IL-6水平均较同组术后第1天明显改善,差异有统计学意义(P<0.05),术后第7天,对照组患者的WBC与IL-6水平均较同Objective To observe the clinical therapeutic effect of thunder-fire moxibustion for the recovery of gastrointestinal function in spleen-stomach deficiency-cold type of patients receiving hyperthermic intraperitoneal chemotherapy(HIPEC)after gastric cancer surgery,and to explore its possible mechanism.Methods A total of 60 spleen-stomach deficiency-cold type of patients who underwent HIPEC after gastric cancer surgery were randomly divided into treatment group and control group,30 cases in each group.The control group received routine treatment and HIPEC treatment after gastric cancer operation,and the treatment group received thunderfire moxibustion at bilateral Zusanli(ST36),Shangjuxu(ST37),Xiajuxu(ST39)acupoints 2 hours after HIPEC treatment for 20 minutes on the basis of the treatment of the control group,once a day,the treatment course covering 7 continuous days.After 7-day treatment,the scores of clinical symptom nausea,emesis,abdominal distension and diarrhea in the two groups were observed day one,3,7 after operation,the clinical therapeutic effect in two groups was evaluated,the changes in time to first intestinal sound,anal exsufflation and defecation,and white blood cells(WBC)count,neutrophils(N)count,C reaction protein(CRP)level and interleukin 6(IL-6)content in blood in the two groups were measured.Results(1)The effective rate for controlling nausea was 90.00%(27/30)in the treatment group,and was 76.67%(23/30)in the control group.The curative efficacy of the treatment group was superior to that of the control group(P<0.05).The total effective rate for controlling emesis was 93.33%(28/30)in the treatment group,and was 76.67%(23/30)in the control group.The curative efficacy of the treatment group was superior to that of the control group(P<0.05).The total effective rate for controlling abdominal distension was 80.00%(24/30)in the treatment group,and was 63.33%(19/30)in the control group.The curative efficacy of the treatment group was superior to that of the control group(P<0.05).The total effective ra

关 键 词：雷火灸 胃癌 脾胃虚寒型 腹腔热灌注化疗 胃肠功能 炎症反应 

分 类 号：R246.9[医药卫生—针灸推拿学]