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电针在直肠癌手术后预防低位前切除综合征中的应用。

Application of electroacupuncture in the prevention of low anterior resection syndrome after rectal cancer surgery.

作者信息

Xu Lu-Lu, Xiang Neng-Jun, Cheng Tian-Cheng, Li Yi-Xian, Chen Peng, Jiang Zhi-Wei, Liu Xin-Xin

机构信息

The First Clinical Medical College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, Jiangsu Province, China.

Department of General Surger, Jiangsu Provincial Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing 210029, Jiangsu Province, China.

出版信息

World J Gastrointest Surg. 2023 Dec 27;15(12):2765-2773. doi: 10.4240/wjgs.v15.i12.2765.

Abstract

BACKGROUND

Low anterior resection syndrome (LARS) is one of the common postoperative complications in patients with rectal cancer, which seriously affects their postoperative recovery and quality of life (QoL). Electroacupuncture therapy is one of the characteristic therapies of traditional Chinese medicine. There are few reports on the prevention and treatment of LARS by electroacupuncture therapy.

AIM

To explore the clinical effectiveness of electroacupuncture in managing rectal cancer patients with postoperative LARS.

METHODS

A total of 50 patients with LARS after rectal cancer surgery were retrospectively selected as the research subjects. According to the treatment methods, they were divided into an observation group ( = 25) and a control group ( = 25). During the four-week treatment period, the control group received standard defecation function training, while the observation group received electroacupuncture care and traditional defecation function training. The anal pressure index (which includes anal resting pressure, anal systolic pressure, and maximum tolerable volume), European Organization of Research and Treatment of Cancer (EORTC) QoL C30 (QLQ-C30) score, LARS Scale (LARSS) score, Wexner anal incontinence scale score, Xu Zhongfa five-item 10-point scale score, and the occurrence of adverse reactions were compared between the two groups before and after treatment.

RESULTS

The experimental group showed considerably enhanced LARSS scores compared to those in the control group after four weeks of treatment. In the first week, second week, and fourth week, the LARSS score and Wexner anal incontinence scale score decreased, and the Xu Zhong method five-item 10-point scale score increased, with significant differences ( < 0.05). The experimental group showed substantial improvements in anal resting pressure, anal systolic pressure, and maximum tolerance volume after undergoing 4 wk of therapy in the untreated group ( < 0.05). The experimental group's QLQ-C30 score on the EORTC QoL questionnaire was higher than that of the control group during the 1, 2, and 4 wk ( < 0.05). No significant variation between the groups in the frequency of adverse reactions ( > 0.05) was observed.

CONCLUSION

Electroacupuncture positively impacted LARS following rectal cancer surgery, effectively improving clinical symptoms and anal pressure indicators and patients' standard of life.

摘要

背景

低位前切除综合征(LARS)是直肠癌患者常见的术后并发症之一,严重影响患者术后康复及生活质量(QoL)。电针疗法是中医特色疗法之一。关于电针疗法防治LARS的报道较少。

目的

探讨电针治疗直肠癌术后LARS患者的临床疗效。

方法

回顾性选取50例直肠癌术后LARS患者作为研究对象。根据治疗方法将其分为观察组(n = 25)和对照组(n = 25)。在为期四周的治疗期间,对照组接受标准排便功能训练,观察组接受电针护理及传统排便功能训练。比较两组治疗前后的肛门压力指数(包括肛门静息压、肛门收缩压和最大耐受容量)、欧洲癌症研究与治疗组织(EORTC)生活质量核心问卷(QLQ-C30)评分、LARS量表(LARSS)评分、Wexner肛门失禁量表评分、徐忠发五项十分制量表评分及不良反应发生情况。

结果

治疗四周后,与对照组相比,试验组LARSS评分显著提高。在第一周、第二周和第四周,LARSS评分及Wexner肛门失禁量表评分降低,徐忠法五项十分制量表评分升高,差异有统计学意义(P < 0.05)。试验组在未治疗组接受4周治疗后,肛门静息压、肛门收缩压和最大耐受容量有显著改善(P < 0.05)。在第1、2和4周,试验组在EORTC生活质量问卷上的QLQ-C30评分高于对照组(P < 0.05)。两组不良反应发生频率差异无统计学意义(P > 0.05)。

结论

电针疗法对直肠癌术后LARS有积极影响,能有效改善临床症状、肛门压力指标及患者生活水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7488/10784840/dd91ba477305/WJGS-15-2765-g001.jpg

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