国际医药卫生导报 ›› 2022, Vol. 28 ›› Issue (11): 1516-1520.DOI: 10.3760/cma.j.issn.1007-1245.2022.11.009

• 科研课题专栏 • 上一篇    下一篇

健脾益气方联合穴位贴敷防治大肠癌术后化疗性胃肠反应的有效性研究

彭树灵1  张卫华1  钟育波2  刘丽丽1  黄红珍1   

  1. 1佛山市第二人民医院中医科,佛山 528000; 2佛山市第二人民医院胃肠外科,佛山 528000
  • 收稿日期:2022-03-08 出版日期:2022-06-01 发布日期:2022-06-15
  • 通讯作者: 彭树灵,Email:peng123shuling@163.com
  • 基金资助:

    广东省中医药局科研项目(20192096);

    广东省名中医(张卫华)传承工作室建设项目(粤中医办函[2020]1号)

Effect of Jianpiyiqi prescription combined with acupoint application in prevention and treatment of chemotherapeutic gastrointestinal reactions after colorectal cancer surgery

Peng Shuling1, Zhang Weihua1, Zhong Yubo2, Liu Lili1, Huang Hongzhen1   

  1. 1 Department of Traditional Chinese Medicine, Foshan Second People 's Hospital, Foshan 528000, China; 

    2 Department of Gastrointestinal Surgery, Foshan Second People 's Hospital, Foshan 528000, China

  • Received:2022-03-08 Online:2022-06-01 Published:2022-06-15
  • Contact: Peng Shuling, Email: peng123shuling@163.com
  • Supported by:

    Project of Guangdong Administration of Traditional Chinese Medicine (20192096); 

    Construction Project of Famous Traditional Chinese Physician (Zhang Weihua) Inheritance Studio in Guangdong Province (No.20201)

摘要: 目的 探讨健脾益气方联合穴位贴敷防治大肠癌术后化疗性胃肠反应的临床疗效。方法 选取2019年1月至2021年11月在佛山市第二人民医院胃肠外科行大肠癌术后化疗患者90例,男49例,女41例,年龄(58±13)岁。采用病例对照研究,90例大肠癌患者按随机数字表法分为对照组、中医组、中西结合组,每组30例。对照组化疗前静脉推注地塞米松10 mg、托烷司琼5 mg,肌肉注射胃复安10 mg。中医组化疗前3 d开始服用健脾益气方,每天1剂,直至化疗结束后3 d;同时贴敷穴位,每天1次,每次持续12 h,直至化疗结束后3 d。中西结合组在对照组的基础上,化疗前3 d开始服用健脾益气方,同时进行穴位贴敷,直至化疗结束后3 d。比较3组患者恶心、呕吐、腹痛腹泻与功能状况的评分的变化及防治效果。采用方差分析与卡方检验。结果 化疗后,对照组、中医组、中西结合组的恶心评分分别为1.00(2.00)分、1.00(2.00)分、1.00(1.00)分,呕吐评分分别为1.00(2.00)分、1.00(2.00)分、1.00(1.00)分,腹泻腹痛评分分别为1.00(2.00)分、0.00(1.00)分、0.00(1.00)分,差异均有统计学意义(均P<0.05)。化疗后,对照组、中医组、中西结合组功能状态评分分别为(91.0±8.4)分、(96.0±6.2)分、(95.7±5.7)分,3组比较,差异有统计学意义(F=4.943,P=0.009)。化疗后,对照组、中医组、中西结合组恶心、呕吐的防治有效率分别为80.00%(24/30)、73.33%(22/30)、96.67%(29/30),3组比较,差异有统计学意义(χ2=6.240,P=0.044)。化疗后,对照组、中医组、中西结合组腹泻腹痛的防治有效率分别为80.00%(24/30)、96.67%(29/30)、96.67%(29/30),3组比较,差异有统计学意义(χ2=6.860,P=0.032)。与对照组比较,中医组、中西结合组的恶心、呕吐评分显著降低,中医组的腹泻腹痛评分显著降低,中医组、中西结合组化疗后功能状态评分显著提高。结论 在常规运用西药止吐药的基础上,采用健脾益气方联合穴位贴敷防治大肠癌术后化疗性胃肠反应具有良好效果。

关键词: 大肠癌, 化疗性胃肠反应, 健脾益气方, 穴位贴敷

Abstract: Objective To investigate the clinical effect of Jianpiyiqi prescription combined with acupoint application in the prevention and treatment of chemotherapeutic gastrointestinal reactions after colorectal cancer surgery. Methods A total of 90 patients taking chemotherapy after colorectal cancer surgery at Department of Gastrointestinal Surgery, Foshan Second People 's Hospital between January 2019 and November 2021 were selected for the case control study, including 49 males and 41 females, and they were (58±13) years old. They were divided into a control group (group A), a traditional Chinese medicine group (group B), and an integrated traditional Chinese and western medicine group (group C), with 30 cases in each group. Group A was given dexamethasone 10 mg, tropisetron 5 mg, and metoclopramide 10 mg by intramuscular injection before the chemotherapy. Group B began to take Jianpiyiqi prescription 3 days before chemotherapy, 1 dose a day, until 3 days after chemotherapy; at the same time, apply acupoints once a day for 12 hours until 3 days after chemotherapy. On the basis of group A, group C began to take Jianpiyiqi prescription 3 days before chemotherapy, and acupoint application was performed until 3 days after chemotherapy. The scores of nausea, vomiting, abdominal pain, diarrhea, and functional status were compared between the three groups. Analysis of variance and chi-square test were used. Results The nausea scores of group A, group B, and group C were 1.00 (2.00), 1.00 (2.00) and 1.00 (1.00), the vomiting scores 1.00 (2.00), 1.00 (2.00) and 1.00 (1.00), and the diarrhea abdominal pain scores 1.00 (2.00), 0.00 (1.00) and 0.00 (1.00) (all P<0.05). The functional status scores before chemotherapy of group A, group B, and group C were (96.3±4.9), (97.7±5.0), and (96.3±5.6); the scores of functional status after chemotherapy of group A, group B, and group C were (91.0±8.4), (96.0±6.2), and (95.7±5.7), with a statistical difference between the 3 groups (F=4.943, P=0.009). The effective rates of nausea, vomiting prevention and treatment were 80.00% (24/30), 73.33% (22/30), and 96.67% (29/30) in group A, group B, and group C, respectively, with a statistical difference between the 3 groups (χ2=6.240, P=0.044). The effective rates of prevention and treatment of diarrhea and abdominal pain were 80.00% (24/30), 96.67% (29/30), and 96.67% (29/30) in group A, group B, and group C, respectively, with a statistical difference between the 3 groups (χ2=6.860, P=0.032). Compared with those in group A, the scores of nausea and vomiting in group B and group C were significantly decreased (all P<0.05), the diarrhea abdominal pain score in group B was significantly lower (P<0.05), and the functional status scores after chemotherapy in group B and group C were significantly increased (both P<0.05). Conclusion On the basis of routine use of western medicine antiemetic drugs, Jianpiyiqi prescription combined with acupoint application has good effect in preventing and treating chemotherapeutic gastrointestinal reactions after colorectal cancer surgery.

Key words: Colorectal cancer, Chemotherapeutic gastrointestinal reactions, Jianpiyiqi prescription, Acupoint application