针刺足三里联合中药灌肠治疗消化道肿瘤术后胃瘫综合征临床研究

来源 :国际中医中药杂志 | 被引量 : 0次 | 上传用户:mmghb
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
目的:探讨针刺足三里联合中药灌肠治疗消化道肿瘤术后胃瘫综合征的疗效。方法:将符合入选标准的2016年6月-2021年5月本院96例消化道肿瘤术后胃瘫综合征患者采用随机抽签法分为3组,每组32例。对照组口服枸橼酸莫沙必利片,中医灌肠组在对照组基础上加用中药灌肠,联合组在中医灌肠组基础上针刺足三里。3组均连续治疗4周。分别于治疗前后对主要证候进行评分,采用放射免疫分析法检测血清促胃液素(gastrin,GAS)、胃动素(motilin,MTL)、生长抑素(somatostatin,SS)水平,采用智能双导胃肠电图仪检测胃电生理参数(波形反应面积、波形频率、平均幅值),记录治疗期间的不良反应,评价临床疗效。结果:联合组总有效率为96.9%(31/32)、中医灌肠组为81.3%(26/32)、对照组为68.8%(22/32),3组比较差异有统计学意义(n χn 2=n 8.72n ,P=0.013)。联合组治疗后脘腹胀满、疲乏无力、嗳气反酸、口干口苦评分低于中医灌肠组与对照组(n F值分别为16.39、13.21、11.28、10.23,n P值均<0.001)。治疗后,联合组GAS[(140.62±15.19)ng/L 比(128.79±14.34)ng/L、(115.98±12.40)ng/L,n F=21.09]、MTL[(268.66±28.21)ng/L比(245.89±25.24)ng/L、(230.78±22.43)ng/L,n F=30.29]、SS[(70.58±8.17)ng/L 比(65.50±7.76)ng/L、(59.73±7.05)ng/L,n F=33.19]水平高于中医灌肠组和对照组(n P<0.01);波形反应面积[(172.62±17.14)μV/s 比(158.56±15.32)μV/s、(145.48±14.13)μV/s,n F=20.24]、波形频率[(3.86±0.61)cpm比(3.29±0.50)cpm、(3.01±0.63)cpm,n F=13.17]、平均幅值[(86.51±8.98)μV比(75.70±7.93)μV、(68.65±7.46)nμV,n F=28.11]高于中医灌肠组和对照组(n P<0.01)。治疗期间,联合组不良反应发生率为18.8%(6/32)、中医灌肠组为15.6%(5/32)、对照组为12.5%(4/32),3组比较差异无统计学意义(n χn 2=n 0.47,n P=0.789)。n 结论:针刺足三里联合中药灌肠可有效改善消化道肿瘤术后胃瘫综合征患者的中医证候、胃肠激素水平、胃电生理参数,提高疗效。“,”Objective:To study the clinical efficacy of acupuncture at Zusanli (ST 36)combined with Traditional Chinese Medicine (TCM) enema in the treatment of gastroparesis syndrome after gastrointestinal tumor operation.Methods:A total of 96 patients with gastroparesis syndrome after gastrointestinal tumor surgery in our hospital from June 2016 to May 2021, who met the inclusion criteria, were randomly divided into three groups by random drawing, with 32 in each group. The control group took mosapride citrate tablets orally, the TCM enema group added TCM enema on the basis of the control group, and the combined group added acupuncture Zusanli (ST 36)on the basis of the TCM enema group. All three groups were treated continuously for 4 weeks. The main syndromes were scored before and after treatment. The levels of serum gastrin (GAS), motilin (MTL) and somatostatin (SS) were detected by radioimmunoassay. The gastric electrophysiological parameters (waveform response area, waveform frequency and average amplitude) were detected by intelligent dual channel gastrointestinal electrograph, the adverse reactions during treatment were recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 96.9% (31/32) in the combined group, 81.3% (26/32) in the TCM enema group and 68.8% (22/32) in the control group. There was significant difference among the three groups (n χ2=8.72, n P=0.013). The scores of abdominal fullness and distention, fatigue, belching acid reflux, dry mouth and bitter mouth in the combined group were significantly lower than those in the TCM enema group and the control group (n F values were 16.39, 13.21, 11.28 and 10.23, respectively, n P<0.001). After treatment, the levels of GAS [(140.62±15.19) ng/Ln vs. (128.79±14.34) ng/L, (115.98±12.40) ng/L, n F=21.09], MTL [(268.66±28.21) ng/L n vs. (245.89±25.24) ng/L, (230.78±22.43) ng/L, n F=30.29] and SS [(70.58±8.17) ng/L n vs. (65.50±7.76) ng/L, (59.73±7.05) ng/L, n F=33.19] in the combined group were significantly higher than those in the TCM enema group and the control group (n P<0.01). The waveform response area [(172.62±17.14) μV/sn vs. (158.56± 15.32) μV/s, (145.48±14.13) μV/s, n F=20.24], waveform frequency [(3.86±0.61) cpmn vs. (3.29±0.50) cpm, (3.01±0.63) cpm, n F=13.17] and average amplitude [(86.51±8.98) μV n vs. (75.70±7.93) μV, (68.65±7.46) μV, n F=28.11] were significantly higher than those in TCM enema group and control group (n P<0.01). During the treatment period, the incidence of adverse reactions was 18.8% (6/32) in the combined group, 15.6% (5/32) in the TCM enema group and 12.5% (4/32) in the control group. There was no significant difference between the three groups (n χ2=0.47, n P=0.789).n Conclusion:Acupuncture at Zusanli (ST 36) combined with TCM enema can improve the TCM syndrome scores, gastrointestinal hormone level and gastric electrophysiological parameters of patients with gastroparesis syndrome after gastrointestinal tumor operation, improve the curative effect with safety.
其他文献
肝上皮样血管平滑肌脂肪瘤(hepatic epithelioid angiomyolipoma,HEAML)是非常罕见的一种血管平滑肌脂肪瘤,由于其缺乏典型的临床及影像学表现极易误诊为肝细胞肝癌.局灶性结节性增生(focal nodular hyperplasia,FNH)亦为少发病例.本文通过分享1例并发HEAML和FNH病例的影像学表现和临床病理特征,以加强临床医师对肝罕见肿瘤的认识,促进经验交流.
胸科手术疼痛剧烈,缺乏有效的疼痛控制,会产生一系列并发症.有效的术后镇痛对患者的恢复至关重要.目前常用的镇痛模式主要有区域镇痛及使用全身静脉镇痛药,不同镇痛方法的联合使用可以获得更好的镇痛效果.现将胸科手术术后疼痛的产生机制及主要的术后镇痛方式加以综述,为减轻胸科手术患者的疼痛、改善患者预后提供参考.
经典Phn -骨髓增殖性肿瘤(MPN)包括真性红细胞增多症(PV)、原发性血小板增多症(ET)和原发性骨髓纤维化(PMF)。伴驱动基因n JAK2、n MPL及n CALR突变是MPN的主要诊断标准之一,骨髓组织病理学特征和非驱动基因突变可以辅助进行MPN诊断和患者预后判断。第1代Janus激酶(JAK)2抑制剂芦可替尼,可快速、显著、持续缩小MPN患者脾体积,并缓解机体症状。多项Ⅲ期临床研究结果证实,第2代JAK抑制剂,如fedratinib、momelotinib和pa
为探索缺氧诱导因子(hypoxia inducible factor,HIF)-1α诱导甲型流感病毒毒株感染小鼠巨噬细胞引起炎症反应的具体机制,本研究以甲型H1N1流感病毒(简称H1N1)株A/PR/8感染小鼠巨噬细胞RAW264.7后,在显微镜下观察其在感染后的表型变化,分别在不同时间段收集样本,通过聚合酶链反应(polymerase chain reaction,PCR)检测HIF-1α、干扰素(interferon,IFN)-γ、白细胞介素(interleukin,IL)-6、肿瘤坏死因子(tumo
两性霉素B(amphotericin B,AMB)是经典的多烯类抗真菌药物,对病原真菌具有广谱抗菌活性,且不易产生耐药性.土曲霉是临床上常见的病原性曲霉,因其对AMB天然耐药而受到关注.现阶段,AMB的抗真菌作用机制有待进一步阐明,且真菌对AMB的耐药机制研究亦不充分.本文就AMB在土曲霉中诱导内源性活性氧(reactive oxygen species,ROS)产生的抗真菌作用机制进行介绍,并重点讨论应激适应通路(热休克蛋白90、热休克蛋白70和钙调磷酸酶)、ROS清除酶以及线粒体功能在土曲霉对AMB耐
心肌梗死(myocardial infarction,MI)在世界范围内被认为是导致心源性死亡的主要原因.MI会导致心脏多种结构和功能的损伤,形成心室重塑,导致心力衰竭、心律失常和心脏破裂,甚至死亡.细胞程序性死亡(programmed cell death,PCD)包括凋亡、焦亡、自噬和铁死亡等不同死亡形式,有别于坏死.研究发现PCD贯穿MI及其之后的心肌损伤和心室重塑等发病过程,在MI的发生发展中发挥重要的作用.
为检测钙离子、镁离子对戊型肝炎病毒(hepatitis E virus,HEV)感染PLC/PRF/5细胞(人肝癌亚历山大细胞)的影响,本研究在各实验组PLC/PRF/5细胞的培养体系中加入等量HEV毒种进行孵育,利用实时荧光定量反转录聚合酶链反应以及酶联免疫法,监测HEV核酸和抗原含量;在HEV感染细胞实验组的维持培养液中分别加入钙离子、镁离子、乙二胺四乙酸(ethylene diamine tetraacetic acid,EDTA)和乙二醇二乙醚二胺四乙酸(ethylene glycol tetra
为观察环介导等温扩增(loop-mediated isothermal amplification,LAMP)技术能否适用于我国不同疫源地鼠疫耶尔森菌所有基因组型的检测,本研究建立了一种基于3a靶序列设计特异性引物快速检测鼠疫耶尔森菌的LAMP方法.选择分离自我国11个鼠疫自然疫源地的65株野生代表性鼠疫耶尔森菌株,同时以与其近源的假结核耶尔森菌、小肠结肠炎耶尔森菌及非近源的大肠埃希菌为对照菌株,观察其敏感性和特异性.结果显示,该LAMP方法与其他3种鼠疫耶尔森菌常规检测方法的结果一致.65株鼠疫耶尔森菌
严重急性呼吸综合征2019(sever acute respiratory syndrome,SARS)、中东呼吸综合征(Middle East respiratory syndrome,MERS)和2019冠状病毒病(corona virus disease 2019,COVID-19)对全世界人民造成了严重的经济损失和精神伤害.鉴于SARS再无新发病例,研究进展少,本文着重介绍MERS和COVID-19的治疗.MERS和COVID-19的治疗大同小异,曾在临床使用核苷类似物、洛匹那韦/利托那韦、中和抗
目的:评价补阳还五汤联合悬吊运动训练治疗脑梗死合并下肢偏瘫的疗效及对下肢功能的影响。方法:将符合入选标准的2017年1月-2021年2月本院94例脑梗死合并下肢偏瘫患者采用随机数字表法分为2组,每组47例。对照组给予悬吊运动训练干预,观察组在对照组基础上服用补阳还五汤。2组均治疗6周,随访3个月。分别于治疗前后进行中医证候评分,采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评估神经功能受损程度,Fuglmeyer下肢运动功