基于脑肠轴理论指导的雷火灸对直肠癌低位前切除综合征的临床疗效观察OA
Observation on the clinical efficacy of thunder-fire moxibustion guided by the brain-gut axis theory for low anterior resection syndrome in rectal cancer
目的 探讨基于脑肠轴理论指导的雷火灸对直肠癌低位前切除综合征的影响.方法 选取2023年10月至2024年10月江苏省中医院普外科收治的66例直肠癌术后发生低位前切除综合征的患者作为研究对象.采用随机数字表法将其分为对照组(常规护理干预组)和观察组(雷火灸组),各33例.剔除脱落病例,研究最终纳入61例患者,对照组31例,观察组30例.比较两组排便功能(采用低位前切除综合征量表评估)、肛门功能(肛管静息压、肛管最大收缩压、直肠最大耐受容积)、血清学指标(皮质醇、5-羟色胺、白细胞介素-6)、生活质量(采用欧洲癌症研究和治疗组织癌症患者生命质量量表评估).结果 治疗4周后,两组低位前切除综合评分低于治疗前,且观察组低于对照组,低位前切除综合分级优于对照组(P＜0.05);两组肛管静息压、肛管最大收缩压和直肠最大耐受容积较治疗前提高,且观察组高于对照组(P＜0.05);两组血清皮质醇、5-羟色胺、白介素-6水平较治疗前下降,且观察组低于对照组(P＜0.05);观察组在5个功能维度、疲乏、睡眠障碍、腹泻和便秘方面优于对照组(P＜0.05).结论 雷火灸可在一定程度上改善低位前切除综合征患者的临床症状,提升肛门控便能力,降低血清皮质醇、5-羟色胺、白介素-6水平,提高低位前切除综合征患者的生活质量.
Objectives To investigate the clinical effect of thunder-fire moxibustion guided by the brain-gut axis theory on low anterior resection syndrome(LARS)in rectal cancer.Methods A total of 66 patients who developed LARS after rectal cancer surgery and were admitted to the Department of General Surgery,Jiangsu Province Hospital of Traditional Chinese Medicine from October 2023 to October 2024 were selected as study subjects.They were divided into a control group(routine care intervention group)and an observation group(thunder-fire moxibustion group)using a random num-ber table method,with 33 patients in each group.After excluding dropouts,61 patients were finally included in the study,with 31 in the control group and 30 in the observation group.The two groups were compared in terms of defeca-tion function(assessed using the LARS Scale),anal function(anal resting pressure,maximum anal squeeze pressure,and maximum tolerable rectal volume),serum biomarkers(cortisol,serotonin[5-HT],interleukin-6[IL-6]),and quality of life(assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30[EORTC QLQ-C30]).Results After 4 weeks of treatment,the LARS scores in both groups were lower than before treat-ment,and the score in the observation group was significantly lower than that in the control group;the LARS severity grade in the observation group was significantly better than that in the control group(P＜0.05).The anal resting pres-sure,maximum anal squeeze pressure,and maximum tolerable rectal volume in both groups increased compared to be-fore treatment levels,these parameters were significantly higher in the observation group than in the control group(P＜0.05).Serum levels of cortisol,5-HT,and IL-6 in both groups decreased compared to before treatment levels,and these levels were significantly lower in the observation group than in the control group(P＜0.05).The observation group showed significantly better outcomes than the control group in five functional domains,fatigue,sleep disturbance,diar-rhea,and constipation(P＜0.05).Conclusion Thunder-fire moxibustion can improve clinical symptoms,enhance anal con-tinence function,reduce serum levels of cortisol,5-HT,and IL-6,and improve the quality of life in patients with LARS to a certain extent.
章颖;许睿;居月月;宫晓晓;王晓红;王欢欢;江志伟;王晓庆
江苏省中医院普外科 江苏 南京 210009江苏省中医院普外科 江苏 南京 210009江苏省中医院普外科 江苏 南京 210009江苏省中医院普外科 江苏 南京 210009江苏省中医院普外科 江苏 南京 210009江苏省中医院普外科 江苏 南京 210009江苏省中医院普外科 江苏 南京 210009江苏省中医院普外科 江苏 南京 210009
医药卫生
直肠癌低位前切除综合征雷火灸脑肠轴生活质量
rectal cancerlow anterior resection syndromethunder-fire moxibustionbrain-gut axisquality of life
《结直肠肛门外科》 2026 (1)
83-89,7
江苏省中医药管理局2024年度省中医药科技发展计划项目(MS2024023)江苏省中医院2023年度南丁格尔专项课题(Y23005)江苏省重点学科项目(ZDXK202251)
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