参苓白术散对大肠癌患者回肠造口排便性状的影响研究  

Effect of Powder of Ginseng,Poria and Bighead Atractylodes on stool characteristics of stoma in patients with colorectal cancer after radical operation and ileostomy

作　　者：赵加应[1] 倪文凯 殷琛庆[1] 周彦 雷卫爱 沈家门 王会鹏[1] 蔡元坤[1] 柯重伟 ZHAO Jiaying;NI Wenkai;YIN Chenqing;ZHOU Yan;LEI Weiai;SHEN Jiamen;WANG Huipeng;CAI Yuankun;KE Chongwei(Shanghai Fifth People’s Hospital Affiliated to Fudan University,Shanghai 200240,China)

机构地区：[1]复旦大学附属上海市第五人民医院,上海200240

出　　处：《现代中西医结合杂志》2023年第22期3087-3091,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：2020年度综合医院中西医结合专项项目(ZHYY-ZXYJHZX-202025);上海市闵行区医疗系统大学科建设专项基金资助项目(2020MWDXK02)。

摘　　要：目的探讨参苓白术散对大肠癌根治加回肠造口患者大便性状、中医证候和机体免疫功能的影响。方法采用前瞻性随机对照研究方法,将复旦大学附属上海市第五人民医院普外科2020年11月—2022年6月收治的70例大肠癌根治加回肠造口术后患者随机分为研究组和对照组,每组35例。研究组给予常规普食+参苓白术散汤剂口服4周,对照组仅给予常规普食,观察2组治疗前及治疗2周、4周后造口大便性状Bristol分型、造口日总排便量、造口排便频率、造口袋更换频率、造口周围粪汁性皮炎发生情况、中医证候积分、肠黏膜屏障功能指标(血清D-乳酸、二胺氧化酶)和免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))变化,统计2组不良反应发生情况。结果与治疗前比较,2组患者治疗2周和4周后造口大便性状逐步成形,造口日总排便量、造口排便频率、造口袋更换频率和造口周围皮炎发生例数逐步减少,中医主症和次症积分逐步降低,肠黏膜屏障功能和细胞免疫功能逐步改善,差异均有统计学意义(P均<0.05),且研究组各指标改善情况均明显优于对照组(P均<0.05)。结论参苓白术散不仅能促进大肠癌根治加回肠造口患者大便成形,减少造口排便量和造口袋更换频率,便于造口管理,且能明显减轻症状,提高机体免疫力,保护肠道黏膜屏障功能。Objective It is to explore the effect of Powder of Ginseng,Poria and Bighead Atractylodes on stool characteristics of stoma,syndrome of traditional Chinese medicine(TCM),immune function of patients after radical resection of colorectal cancer and ileostomy.Methods A prospective randomized controlled study was used to randomly divide 70 patients who were admitted to the group from November 2020 to June 2022 in the Department of General Surgery of Shanghai Fifth People’s Hospital Affiliated to Fudan University after radical resection of colorectal cancer and ileostomy into the study group and the control group,with 35 cases in each group.The study group was treated with regular normal diet+ oral administration of Powder of Ginseng,Poria and Bighead Atractylodes for 4 weeks,and the control group was treated with regular normal diet for 4 weeks.The Bristol classification of stoma stool characteristics,total daily stool output,defecation frequency of stoma,replacement frequency of stoma pocket,occurrence of faecal dermatitis around stoma,TCM symptoms,indexes of intestinal mucosal barrier function(serum D-lactate,diamine oxidase)and immune function(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))of the two groups were observed before treatment and after 2 and 4 weeks of treatment,the occurrences of side effects were counted in the two groups.Results Compared with before treatment,the stoma stool was gradually shaped,the total daily stool output,defecation frequency of stoma,replacement frequency of stoma pocket,occurrence of faecal dermatitis around stoma were gradually reduced,the scores of primary and secondary symptoms of TCM were gradually decreased,and the intestinal mucosal barrier function and cellular immune function were gradually improved,the differences were all statistically significant(all P<0.05),and the improvement of each index of the study group was significantly better than that of the control group(all P<0.05).Conclusion Powder of Ginseng,Poria and Bighead Atractylodes not only can promote stool shape,reduce stoma

关 键 词：参苓白术散 大肠癌手术 回肠造口 排便性状 免疫功能 

分 类 号：R735.34[医药卫生—肿瘤]