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目的探讨针药并用外治法治疗消化道肿瘤术后胃瘫患者的临床疗效。方法选取2013年8月至2016年8月间首都医科大学附属北京中医医院及中国医学科学院肿瘤医院收治的106例消化道肿瘤术后胃瘫患者,采用前瞻性和随机对照的研究设计,采用随机数表法进行随机分组,用不透光的信封进行分配隐藏,将患者分为治疗组和对照组。治疗组患者在基本治疗的基础上加用针刺联合中药穴位贴敷。对照组患者在基本治疗的基础上加用甲氧氯普胺注射液肌内注射。连续使用至胃瘫缓解,最长疗程为21天。观察胃瘫缓解率、症状积分、胃液引流量、胃管拔出时间及体力状态得分。结果在干预第1周、第2周和第3周治疗组患者胃瘫缓解痊愈率和有效率均高于对照组,组间比较差异均有统计学意义(均P<0.01)。第2周、第3周和第4周时,治疗组患者胃瘫症状积分总分低于对照组患者,组间比较差异均有统计学意义(均P<0.01)。治疗后第3、5、7、9、14及21天时,治疗组患者的胃液引流量均低于对照组患者,两组比较差异均有统计学意义(均P<0.01)。治疗组患者的胃管拔除时间低于对照组患者,组间比较差异有统计学意义(P<0.05)。治疗第2周、第3周和第4周,治疗组患者体力状况评分高于对照组患者,差异有统计学意义(P<0.01)。结论针药并用外治法可改善消化道肿瘤术后胃瘫患者术后消化道症状,减少胃液引流量。
Objective To investigate the clinical effects of acupuncture combined with external treatment on patients with gastroparesis after digestive tract tumor surgery. Methods From August 2013 to August 2016, 106 patients with postoperative gastrointestinal paralysis treated by Beijing Capital Medical University Affiliated Beijing Hospital of Traditional Chinese Medicine and Chinese Academy of Medical Sciences and Cancer Hospital were prospectively and randomly controlled. Randomized controlled trials Number of tables were randomly divided into groups, with opaque envelopes for distribution hidden, the patients were divided into treatment group and control group. Treatment group patients on the basis of basic treatment plus acupuncture combined with acupuncture point application. Patients in the control group were treated with metoclopramide injection intramuscularly on the basis of basic treatment. Continuous use to stomach paralysis ease, the longest course of treatment for 21 days. Observe the rate of gastric paralysis, symptom score, gastric drainage, gastric tube pull-out time and physical status scores. Results In the first week, the second week and the third week of intervention, the cure rate and the effective rate of gastric paralysis were higher in the treatment group than in the control group. There were significant differences between the two groups (all P <0.01). At week 2, week 3 and week 4, the scores of gastroparesis symptom scores in the treatment group were lower than those in the control group. There were significant differences between the two groups (all P <0.01). At the 3rd, 5th, 7th, 9th, 14th and 21st days after treatment, the gastric fluid drainage volume in the treatment group was lower than that in the control group. There was significant difference between the two groups (all P <0.01). The gastric tube removal time in the treatment group was lower than that in the control group, the difference was statistically significant (P <0.05). At the second week, the third week and the fourth week, the scores of physical status in the treatment group were higher than those in the control group, with statistical significance (P <0.01). Conclusion Acupuncture combined with external treatment can improve postoperative gastrointestinal symptoms of patients with gastrointestinal paralysis after gastrointestinal cancer and reduce gastric fluid drainage.