针刺联合通幽汤对痰瘀互结型食管癌术后患者康复的影响及机制  

Mechanism and effect of acupuncture combined with Tongyou Decoction on recovery of postoperative patients with esophageal cancer of binding of phlegm and blood stasis

作　　者：韩雪 刘磊 樊志伟 HAN Xue;LIU Lei;FAN Zhi-wei(Department of Acupuncture and Moxibustion of Taihe Hospital of Traditional Chinese Medicine Attached to Anhui University of Traditional Chinese Medicine,Taihe 236600,China;No.3 Surgery Department,Taihe Hospital of Traditional Chinese Medicine Attached to Anhui University of Traditional Chinese Medicine,Taihe 236600)

机构地区：[1]安徽中医药大学附属太和中医院针灸科,太和236600 [2]安徽中医药大学附属太和中医院外三科,太和236600

出　　处：《北京中医药》2024年第1期48-52,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：2020年度安徽省中医药传承创新科研项目(中医药科研课题)(2020ccyb21)。

摘　　要：目的观察针刺联合通幽汤对食管癌术后患者康复的影响,并探讨其可能的作用机制。方法采用前瞻性研究方法,选取2021年1月—2023年1月太和县中医院收治的痰瘀互结型食管癌患者80例,采用随机数字表法分为对照组和观察组。2组均给予常规手术治疗,对照组术后给予常规对症支持治疗,同时给予抗感染治疗。观察组术后常规治疗方法同对照组,加针刺联合通幽汤治疗。均连续治疗7 d。对比2组首次肛门排气时间、疼痛消失时间、胸管拔除时间、首次进流质饮食时间、引流管拔除时间、住院时间;术前和术后第8天中医证候积分、血清炎症因子(IL-6、TNF-α、CRP)、氧化应激指标(SOD、MDA和GSH-Px)、免疫指标(Th17、Treg细胞比例,Th17/Treg)。结果观察组首次肛门排气时间、疼痛消失时间、胸管拔除时间、首次进流质饮食时间、住院时间均较对照组短(P<0.05);2组引流管拔除时间比较差异无统计学意义(P>0.05)。术后第8天,2组各项症状中医证候积分均较术前降低(P<0.05),且观察组食欲不振、胸胁疼痛评分低于对照组(P<0.05);2组血清IL-6、TNF-α、CRP、MDA、Treg细胞比例均较术后第1天下降(P<0.05),2组SOD、GSH-Px、Th17细胞比例、Th17/Treg较术后第1天上升(P<0.05),且观察组以上指标变化较对照组明显(P<0.05)。结论针灸联合通幽汤加减可通过减轻炎症、氧化应激和调节免疫平衡等促进食管癌患者术后快速康复。Objective To investigate the mechanism and therapeutic effect of acupuncture combined with Tongyou Decoction in promoting postoperative recovery with esophageal cancer.Objective Using prospective research methods,a total of 80 patients admitted to the Taihe County Hospital of Traditional Chinese Medicine for esophageal cancer surgery from January 2021 to January 2023 were selected and divided into observation group and control group by random number table method.Both groups were operated.The control group was given conventional symptomatic support treatment after operation and anti-infection treatment at the same time,and the observation group was treated with the same method as the control group after operation and plus acupuncture in combination with Tongyou Decoction.Both groups were treated for 7 days continuously.The first anal exhaust time,the pain resolution time,the chest tube removal time,the first feeding time,drainage tube pull-out time and hospitalization time;scores of TCM syndromes before and 8 days after operation,and the levels of serum inflammatory factors(IL-6,TNF-α,CRP),oxidative stress indexes(SOD,MDA and GSH-Px)and immune index(Th17,Treg cell ratio,Th17/Treg)were compared before and after treatment.Results The observation group showed less time of first anal exhaust,disappearance of pain,removal of thoracic drainage tube,and time of first oral intake of liguid diet and hospitalization compared to the control group(P<0.05).There was no significant difference in the time of pulling out the drainage tube between the two groups(P>0.05).On the 8th day after operation,the scores of TCM syndrome in both groups were reduced compared with that before the treatment(P<0.05),and the improvement of loss of appetite and chest pain in the observation group was better than that in the control group(P<0.05).The proportion of serum IL-6,TNF-α,CRP,MDA and Treg cells in the two groups decreased compared with the first day after operation(P<0.05),while the proportion of SOD,GSH-Px,Th17 cells and Th17/Treg in th

关 键 词：食管癌 针刺 通幽汤 快速康复 机制 

分 类 号：R273[医药卫生—中西医结合]