加减半夏泻心汤治疗结直肠癌术后胃肠功能障碍疗效观察及对血清肿瘤标志物的影响  

Observation on Curative Effect of Modified Banxia Xiexin Decoction for Gastrointestinal Dysfunction After Colorectal Cancer Surgery and Its Effect on Serum Tumor Markers

作　　者：赵蕾 徐天生 郑康 ZHAO Lei;XU Tiansheng;ZHENG Kang

机构地区：[1]温州医科大学附属衢州医院(衢州市人民医院)肛门盆底外科,浙江衢州324000

出　　处：《新中医》2023年第8期24-27,共4页New Chinese Medicine

摘　　要：目的:观察加减半夏泻心汤治疗肝脾不和型结直肠癌术后胃肠功能障碍临床疗效及其对血清肿瘤标志物的影响。方法:纳入结直肠癌根治术后出现胃肠功能障碍的肝脾不和型患者105例,按随机数字表法分为研究组53例与对照组52例。2组术后均给予肠内营养支持、维持水电解质平衡等常规治疗;对照组术后加用盐酸洛哌丁胺胶囊、胃复安注射液对症治疗,研究组术后给予加减半夏泻心汤治疗。治疗后观察2组临床疗效、中医证候积分、胃肠功能恢复时间及血清肿瘤标志物[糖类抗原199 (CA199)、糖类抗原724 (CA724)及癌胚抗原(CEA)]水平。结果:研究组总有效率为98.11%,高于对照组86.54%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组中医证候积分比较,差异无统计学意义(P>0.05);治疗后,2组中医证候积分均较治疗前降低(P<0.05),且研究组中医证候积分低于对照组(P<0.05)。研究组首次排气时间、首次排便时间、肠鸣音恢复时间均明显早于对照组,差异有统计学意义(P<0.05)。治疗前,2组血清CA199、CA724、CEA水平比较,差异无统计学意义(P>0.05);治疗后,2组上述各项指标均较治疗前降低(P<0.05),且研究组各项指标均低于对照组(P<0.05)。结论:加减半夏泻心汤治疗肝脾不和型结直肠癌术后胃肠功能障碍疗效显著,可下调血清肿瘤标志物水平,有利于缓解患者临床症状,促进胃肠功能恢复。Objective:To observe the clinical effect of modified Banxia Xiexin Decoction for gastrointestinal dysfunction of disharmony between liver and spleen type after colorectal cancer surgery and its effect on serum tumor markers.Methods:A total of 105 cases of patients with gastrointestinal dysfunction of disharmony between liver and spleen type after radical resection of colorectal cancer were enrolled and divided into the study group and the control group according to the random number table method,with 53 and 52 cases in each group respectively.After surgery,both groups were given routine treatment such as enteral nutrition support and water electrolyte balance;the control group was additionally given Loperamide Hydrochloride Capsules and Metoclopramide Injection for symptomatic treatment;the study group was additionally treated with modified Banxia Xiexin Decoction.After treatment,the clinical effects,the traditional Chinese medicine(TCM)syndrome scores,the recovery time of gastrointestinal function, and the levels of serum tumor markers including carbohydrate antigen199 (CA199),carbohydrate antigen 724 (CA724),and carcinoembryonic antigen (CEA) in the two groupswere observed. Results: The total effective rate was 98.11% in the study group, higher than that of86.54% in the control group, the difference being significant (P<0.05). Before treatment, there was nosignificant difference being found in the comparison of TCM syndrome scores between the two groups (P>0.05);after treatment, TCM syndrome scores in the two groups were decreased when compared withthose before treatment (P<0.05),and TCM syndrome scores in the study group were lower than those inthe control group (P<0.05). The first exhaust time, the first defecation time, and the recovery time ofbowel sound in the study group were significantly earlier than those in the control group,differences beingsignificant (P<0.05). Before treatment,there was no significant difference being found in the comparisonof levels of CA199,CA724,and CEA in serum between the two

关 键 词：结直肠癌术后 胃肠功能障碍 肝脾不和 半夏泻心汤 肿瘤标志物 

分 类 号：R57[医药卫生—消化系统] R735.35[医药卫生—内科学]