针刺疗法促进结直肠癌患者术后肠道功能恢复的疗效研究  

Effect of acupuncture on postoperative intestinal function recovery in patients with colorectal cancer

作　　者：刘雪妍 黄剑 姚昊 杨艳蓉 郑入文[2] Liu Xueyan;Huang Jian;Yao Hao;Yang Yanrong;Zheng Ruwen(The Second Clinical Medical College of Beijing University of Traditional Chinese Medicine,Beijing 100078,China;Department of Acupuncture,Dongfang Hospital,Beijing University of Traditional Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学第二临床医学院,100078 [2]北京中医药大学东方医院针灸科,100078

出　　处：《中华结直肠疾病电子杂志》2021年第6期605-612,共8页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：国家自然科学基金项目(No.81904287);北京中医药大学东方医院1166人才培养项目(No.030903010301);北京中医药大学青年教师基金项目(No.2017-JYB-JS-112)。

摘　　要：目的观察针刺疗法对结直肠癌患者术后肠道功能恢复的作用。方法将68例结直肠癌术后患者随机分为针刺组33例,对照组35例。针刺组在快速康复外科(ERAS)方案基础上,予针刺双侧足三里、上巨虚、合谷、内关穴,术后第1天开始每天治疗1次,共治疗4天;对照组无针刺治疗。比较两组术后肠鸣音恢复、首次排气、排便时间、进食流质时间、下床活动时间、术后住院天数等术后恢复情况,术后疼痛评分,术后并发症与不良事件等指标的变化。结果针刺组与对照组在术后肠鸣音恢复时间、首次排气时间、首次排便时间、首次进食流质时间、首次下床活动时间、术后住院天数的差异无统计学意义(均P>0.05);针刺组直肠癌患者的术后首次排气时间(t=2.250,P<0.05)、排便时间(t=3.350,P<0.05)、进食流质饮食时间(t=2.643,P<0.05)明显短于结肠癌患者;两组患者术后第一天VAS评分差异有统计学意义(t=-2.212,P<0.05);术后第二天(t=-1.826,P>0.05)、术后第三天(t=-1.170,P>0.05)VAS评分差异无统计学意义;术后第四天,差异有统计学意义(t=2.015,P<0.05),两组在术后第一天到第四天的疼痛评分下降值差异有统计学意义(t=-2.813,P<0.01);两组在术后并发症及不良事件的发生情况上差异无统计学意义(均P>0.05)。结论在本次研究中,针刺改善术后即时疼痛疗效显著,但在术后肠道功能恢复上未显现出明确的疗效,后续需要进一步大样本的研究来提供更充分的数据支持。Objective To observe the effect of acupuncture on the recovery of intestinal function in patients with colorectal cancer after operation.Methods Sixty-eight patients with colorectal cancer were randomly divided into acupuncture group(33 cases)and control group(35 cases).The acupuncture group was given acupuncture at Zusanli,Shangjuxu,Hegu and Neiguan on both sides on the basis of eras scheme,once a day from the first day after operation,for 4 days;There was no acupuncture treatment in the control group.The recovery of bowel sounds,first exhaust,defecation time,fluid intake time,ambulation time,postoperative hospital stay,postoperative pain score,postoperative complications and adverse events were compared between the two groups.Results There was no significant difference between the acupuncture group and the control group in postoperative bowel sound recovery time,first exhaust time,first defecation time,first fluid intake time,first ambulation time and postoperative hospital stay(P>0.05);The first postoperative exhaust time(t=2.250,P<0.05),defecation time(t=3.350,P<0.05)and liquid diet time(t=2.643,P<0.05)of rectal cancer patients in acupuncture group were significantly shorter than those in colon cancer patients;There was significant difference in VAS score between the two groups on the first day after operation(t=-2.212,P<0.05);There was no significant difference in VAS score on the second day(t=-1.826,P>0.05)and the third day(t=-1.170,P>0.05);On the fourth day after operation,the difference was significant(t=2.015,P<0.05).There was significant difference in the decrease of pain score between the two groups from the first day to the fourth day after operation(t=-2.813,P<0.01);There was no significant difference in the incidence of postoperative complications and adverse events between the two groups(P>0.05).Conclusion In this study,acupuncture has a significant effect on improving immediate postoperative pain,but it does not show a clear effect on the recovery of postoperative intestinal function.Further large

关 键 词：针刺 结直肠肿瘤 肠道功能 加速康复外科 

分 类 号：R246.5[医药卫生—针灸推拿学]