董氏奇穴结合丁沉扶正汤对胃癌术后胃肠功能紊乱患者胃肠功能及血清SS、VIP表达的影响

Effect of Dongshi Qixue combined with Dingchen Fuzheng Decoction on gastrointestinal function and serum somatostain and vasoactive intestinal peptide expression in patients with gastrointestinal dysfunction after gastric cancer surgery

关键词:  董氏奇穴  丁沉扶正汤  胃癌  胃肠功能紊乱

Key words:  Dongshi Qixue  Dingchen Fuzheng Decoction  gastric cancer  gastrointestinal dysfunction

摘要:

[目的] 研究董氏奇穴结合丁沉扶正汤对胃癌术后胃肠功能紊乱患者胃肠功能及血清生长抑素（SS）、血管活性肠肽（VIP）表达的影响。[方法] 本研究采用前瞻性研究，以河北省退役军人总医院2019年3月—2020年3月诊断并腹腔镜手术治疗的120例胃癌术后胃肠功能紊乱患者作为研究对象，按照随机分组原则，基础组采用常规治疗，针刺组采用普通针刺治疗，奇穴组采用董氏奇穴针刺治疗，联合组采用董氏奇穴结合丁沉扶正汤治疗。比较4组患者的症状体征评分、临床指标、胃肠功能障碍评分、急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）以及腹腔压力、血清学指标和不良反应之间的差异。[结果] 经过治疗后，4组患者的腹胀、疼痛、呕吐以及纳差等评分均显著下降，且联合组患者的腹胀、疼痛、呕吐以及纳差评分均显著低于其他组（P<0.05）；联合组患者的饮食时间、肠鸣音恢复时间、排气时间、排便时间以及下床活动时间均显著低于其他组（P<0.05）；4组患者的胃肠功能障碍评分、APACHEⅡ以及腹腔压力均显著下降，且联合组患者的胃肠功能障碍评分、APACHEⅡ以及腹腔压力低于其他组（P<0.05）；4组患者的SS、VIP水平均显著下降，且联合组患者的SS、VIP水平显著低于其他组（P<0.05）；4组患者治疗期间发生腹泻、发热以及皮疹之间的差异无统计学意义（P>0.05）。[结论] 胃癌术后患者采取董氏奇穴结合丁沉扶正汤治疗，患者的胃肠功能紊乱显著恢复，血清SS、VIP下调，效果显著。

Abstract:

[Objective] To study the effect of Dongshi Qixue combined with Dingchen Fuzheng Decoction on gastrointestinal function and serum somatostain(SS),vasoactive intestinal peptide(VIP) expression in patients with gastrointestinal dysfunction after gastric cancer surgery.[Methods] This study adopts a prospective study,taking 120 cases of gastric cancer patients with postoperative gastrointestinal dysfunction diagnosed and treated by laparoscopic surgery in our hospital from March 2019 to March 2020 as the research object. According to the principle of randomization,the basic group received conventional treatment,the acupuncture group received ordinary acupuncture treatment,and the odd-point acupuncture group received Dongshi Qixue acupuncture treatment. The combined group was treated with Dongshi Qixue combined with Dingchen Fuzheng Decoction. The scores of symptoms and signs,clinical indicators,gastrointestinal dysfunction score,acute physiology and chronic health status score Ⅱ(APACHE Ⅱ),abdominal pressure,serological indicators and adverse reactions in 4 groups were compared.[Results] After treatment,the scores of abdominal distension,pain,vomiting and tolerance decreased significantly in the 4 groups,and the abdominal distension,pain,vomiting and tolerance were significantly lower than those in other groups(P<0.05);The time to diet,bowel sound recovery time,exhaust time,defecation time and time to get out of bed were significantly lower than those in other groups(P<0.05);Gastrointestinal dysfunction score,APACHEⅡ and abdominal pressure were significantly decreased in 4 groups,and gastrointestinal dysfunction score,APACHEⅡ and abdominal pressure in the combined group was lower than other groups;The levels of SS and VIP in 4 groups were significantly decreased(P<0.05),and the levels of SS and VIP in combined group were significantly lower than those in other groups(P<0.05). There was no significant difference in diarrhea,fever and rash between 4 groups during treatment (P>0.05).[Conclusion] Patients with gastric cancer after operation were treated with Dongshi Qixue combined with Dingchen Fuzheng Decoction. The gastrointestinal dysfunction of patients was significantly restored,and the serum SS and VIP were down regulated.