Abstract:

Objective　To explore the effect of triple therapy of traditional Chinese medicine combined with enhanced recovery after surgery (ERAS) on gastrointestinal function recovery after laparoscopic colorectal cancer surgery. Methods　A total of 60 patients who underwent laparoscopic colorectal cancer surgery at Changde Hospital, Hunan University of Traditional Chinese Medicine from April 2019 to February 2020 were selected and divided into a treatment group and a control group by random number table method, with 30 patients in each group. There were 17 males and 13 females in the treatment group, and they were (57.8±8.9) years old. There were 15 males and 15 females in the control group, and they were (58.4±7.7) years old. Both groups adopted the ERAS concept for perioperative preparation, and the treatment group additionally took Chinese medicine triple therapy (ear point pressing bean, moxibustion, and Chinese medicine hot ironing). The postoperative auscultation times of first bowel sound, first anal exhaust times, first defecation times, and postoperative abdominal pain scores were observed and compared between the two groups. t test and MANOVA of repeated measuring were applied. Results　The postoperative auscultation time of first bowel sound, first anal exhaust time, and first defecation time were (12.99±1.16) h, (29.91±2.28) h, and (52.39±6.17) h in the treatment group, and were (19.50±0.97) h, (32.68±1.14) h, and (60.63±4.18) h in the control group, with statistical differences (t=5.139, 3.516, and 10.037; P=0.028, 0.032, and 0.013). The pain scores 1, 3, and 5 days after the surgery were (3.57±0.63), (2.83±0.59), and (1.50±0.68) in the treatment group, and were (4.07±0.45), (3.23±0.43), and (1.73±0.58) in the control group, with statistical differences in the pain scores 1 and 3 days after the surgery (P=0.011 and 0.004) but no statistical difference in the pain score 5 days after the surgery (P=0.160). Conclusion　Triple therapy of traditional Chinese medicine combined with ERAS for patients after laparoscopic colorectal cancer surgery can effectively promote their postoperative gastrointestinal function recovery, and has clinical significance in promoting their postoperative rapid recovery.

Key words:

Laparoscopic colorectal cancer surgery, Enhanced recovery after surgery, Triple therapy of traditional Chinese medicine, Gastrointestinal function

摘要： 目的　探究中医三联疗法结合加速康复外科（ERAS）对腹腔镜结直肠癌患者术后胃肠功能恢复的影响。方法　选择2019年4月至2020年2月期间于湖南中医药大学附属常德医院行腹腔镜结直肠癌手术的患者共60例，随机数字表法分为治疗组与对照组，每组30例。治疗组男17例，女13例，年龄（57.8±8.9）岁；对照组男15例，女15例，年龄（58.4±7.7）岁。两组均采用ERAS理念行围术期准备，治疗组加用中医三联疗法（耳穴压豆、艾灸、中药热熨）治疗，比较两组患者的术后首次听诊到肠鸣音时间、肛门首次排气时间、首次排便时间、术后腹痛评分。统计学采用t检验、重复测量方差分析。结果　治疗组首次听诊到肠鸣音时间为（12.99±1.16）h、肛门首次排气时间为（29.91±2.28）h、首次排便时间为（52.39±6.17）h，对照组分别为（19.50±0.97）h、（32.68±1.14）h、（60.63±4.18）h，两组比较，差异均有统计学意义（t=5.139、3.516、10.037，P=0.028、0.032、0.013）。治疗组术后1 d疼痛评分为（3.57±0.63）分、术后3 d为（2.83±0.59）分、术后5 d为（1.50±0.68）分，对照组分别为（4.07±0.45）分、（3.23±0.43）分、（1.73±0.58）分，治疗组术后1 d、3 d疼痛评分低于对照组，差异均有统计学意义（P=0.011、0.004），术后5 d两组比较差异无统计学意义（P=0.160）。结论　中医三联疗法结合ERAS能有效促进患者术后胃肠功能恢复，对促进患者术后快速康复有一定临床意义。

关键词: 腹腔镜结直肠癌术, ERAS, 中医三联疗法, 胃肠功能