中药穴位热熨敷的不同推熨频率对促进结肠癌根治术后患者胃肠功能恢复的影响

Effects of different frequencies of traditional Chinese medicine acupoint hot compress on promoting the recovery of gastrointestinal function in patients after radical surgery for colon cancer

关键词:  频率  中药热熨敷  结肠癌  胃肠功能

Key words:  different frequencies  traditional Chinese medicine hot compress  colon cancer  gastrointestinal function

摘要:

[目的] 观察中药穴位热熨敷的不同推熨频率对促进结肠癌根治术后患者胃肠功能恢复的影响。[方法] 选取 2020年1月—2023年3月在广州中医药大学第一附属医院二外科住院的腹腔镜下结肠癌根治术后患者 108 例，随机分为试验 A 组、试验 B 组、对照组各 36 例。对照组采用常规护理方法，试验组在常规护理基础上实施子午流注理论指导下的中药热熨敷干预，试验 A 组的推熨频率为 90~95 次/min，试验 B 组的推熨频率为 115~120 次/min，从术后第 1 天开始，每日 2 次，直至肛门排气和排便。观察 3 组患者胃肠功能恢复、住院时间、中医证候积分变化情况以及不良反应发生情况，评价 3 组患者的临床疗效。[结果] 干预后，试验 B 组术后肠鸣音恢复时间、首次肛门排气时间明显短于试验 A 组和对照组（P＜0.05），试验 B 组首次排便时间和术后住院时间均明显短于对照组（P＜0.05 或 P＜0.01）；3 组患者中医证候积分的组间效应、时间效应及交互效应均有统计学差异（P＜0.05）；3 组患者中医证候积分随时间推移均呈下降趋势，试验 B 组术后 72 h 的中医证候积分低于试验 A 组和对照组，且试验 A 组低于对照组（P＜0.05）；试验 A 组和试验 B 组的临床治疗总有效率均明显优于对照组（P＜0.05）。[结论] 中药热熨敷能有效促进结肠癌根治术后患者胃肠功能恢复，以推熨频率为 115~120 次/min 的整体治疗效果更为显著。

Abstract:

[Objective] To observe the effects of different frequencies of traditional Chinese medicine （TCM） hot compress on promoting the recovery of gastrointestinal function in patients after radical surgery for colon cancer. [Methods] A total of 108 patients after laparoscopic radical resection of colon cancer who were hospitalized in the Second Surgery Department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2020 to March 2023 were randomly divided into test group A，test group B and control group，each with 36 cases. The control group was treated with routine nursing，and the test group was treated with TCM hot compress intervention under the guidance of the theory of meridian flow on the basis of routine nursing. The frequency of test group A was 90-95 times/min，and the frequency of test group B was 115 to 120 times/min，twice a day from the first day after operation，until anal exhaust and defecation. The recovery of gastrointestinal function，the length of hospital time，the change of the TCM symptomatology scores，and the occurrence of adverse reactions were observed in the three groups，and the clinical efficacy of the three groups was evaluated. [Results] After the intervention，the postoperative bowel sound recovery time and the time of the first anal exhaust were significantly shorter in test group B than in test group A and the control group （P＜0.05），and the time of the first defecation and postoperative hospital time were significantly shorter in test group B than in the control group （P＜0.01 or P＜0.05）. The between-group effect，the time effect，and the interaction effect of the TCM symptomatology scores of the patients in the three groups were all significant （P＜0.05）. The TCM symptomatology scores of the three groups demonstrated a consistent decline over time. After 72 hours of surgery，the TCM symptomatology scores of the test group B were lower than those of the test group A and the control group，and the test group A was lower than that of the control group （P＜0.05）. The total effectiveness of the clinical treatments of the test group A and the test group B were significantly better than that of the control group（P＜0.05）. [Conclusion] TCM hot compress can effectively promote the recovery of gastrointestinal function in patients after radical surgery for colon cancer. The overall therapeutic effect is more significant when the frequency of hot compress is 115 to 120 times/min.