柴芪疏肝调脾方联合生物反馈对腹腔镜直肠癌低位保肛术后胃肠、肛门功能指标恢复的影响  

Effect of Chaiqi Shugan Tiaopi Recipe combined with biofeedback on recovery of gastrointestinal and anal function after laparoscopic anus preserving surgery for rectal cancer

作　　者：王妮[1] 贺屹巍 陈燕京 万俊华[2] 彭红[1] 付珊珊 张默然 WANG Ni;HE Yi-wei;CHEN Yan-jing(Surgery of Digestive Neoplasms,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang Hebei 050000,China)

机构地区：[1]河北省中医院消化肿瘤外科,河北石家庄050000 [2]河北省中医院感染科,河北石家庄050000

出　　处：《临床和实验医学杂志》2023年第5期491-495,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2020117)。

摘　　要：目的观察柴芪疏肝调脾方联合生物反馈对腹腔镜直肠癌低位保肛术后胃肠、肛门功能指标恢复的影响。方法采用前瞻性研究,将2019年4月至2022年4月在河北省中医院接受腹腔镜直肠癌低位保肛术治疗的80例患者采用简单随机法分为两组,每组40例。对照组术后给予生物反馈治疗,观察组在生物反馈基础上联合柴芪疏肝调脾方治疗。比较两组治疗前后肠道菌群、肛门功能、生活质量评分,统计两组不良反应和低位直肠前切除综合征(LARS)发生率。结果治疗后,观察组大肠埃希菌、肠球菌较治疗前下降,而乳杆菌、双歧杆菌/大肠杆菌(B/E)值较治疗前升高,差异均有统计学意义(P<0.05);对照组治疗后肠道菌群与治疗前比较,差异无统计学意义(P>0.05);观察组治疗后大肠埃希菌、肠球菌低于对照组,乳杆菌、B/E值高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组肛管静息压、肛管最大收缩时间、直肠便意感觉容量、直肠最大耐受容量、直肠顺应性均较前升高,直肠静息压较治疗前下降,差异均有统计学意义(P<0.05);观察组治疗后肛管静息压、直肠便意感觉容量高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组生活质量评分均较治疗前升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。观察组累计不良反应发生率为30.00%,与对照组的40.00%比较,差异无统计学意义(P>0.05)。观察组术后3个月和术后6个月累计LARS发生率为40.00%,低于对照组的82.50%,差异有统计学意义(P<0.05)。结论柴芪疏肝调脾方联合生物反馈可促进腹腔镜直肠癌低位保肛术后肛门功能的恢复,有助于稳定肠道菌群,预防LARS的发生,提高生活质量。Objective To observe the effect of Chaiqi Shugan Tiaopi Formula combined with biofeedback on the recovery of gastrointestinal and anal function after laparoscopic anus preserving surgery for rectal cancer.Methods From April 2019 to April 2022,80 patients with rectal cancer who underwent laparoscopic low anal preservation surgery in Hebei Hospital of Traditional Chinese Medicine were divided into two groups by simple random method,with 40 cases in a single group.The control group was given biofeedback treatment after surgery,and the observation group was treated with Chaiqi Shugan Tiaopi prescription on the basis of biofeedback.The scores of intestinal microbiota,anal function and quality of life before and after treatment were compared between the two groups.The incidence of adverse reactions and low anterior rectal resection syndrome(LARS)were analyzed.Results After treatment,the number of Escherichia coli and enterococcus decreased,while the number of Lactobacillus,Bifidobacterium/Escherichia coli(B/E)increased,the differences were statistically significant(P<0.05).There was no statistically significant difference in intestinal flora between the control group after treatment and before treatment(P>0.05).After treatment,the levels of Escherichia coli and enterococcus in the observation group were lower than those in the control group,while the values of lactobacillus and B/E in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).After treatment,the anal resting pressure,the maximum contraction time of the anal canal,the rectal stool sensation capacity,the rectal maximum tolerance capacity,and the rectal compliance in both groups were higher than before,and the rectal resting pressure was lower than before,the differences were statistically significant(P<0.05).After treatment,the anal canal resting pressure and rectal stool sensation volume in the observation group were higher than those in the control group,the differences were statistically si

关 键 词：柴芪疏肝调脾方 生物反馈 直肠癌 低位保肛术 肛门功能 低位直肠前切除综合征 

分 类 号：R735.37[医药卫生—肿瘤]