目的 探索艾灸对胃癌根治术后患者早期喂养耐受性及C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α、血浆D-乳酸水平的影响,为胃癌根治术后肠内营养实施方案提供证据支持。方法 采用随机对照试验设计,选择2023年4月至2025年6月于江苏省中医院行胃癌根治术的患者140例,采用随机数字表法将其分为对照组(70例,剔除3例)、试验组(70例,剔除2例、脱落1例),对照组采用胃癌根治术后护理常规及早期肠内营养治疗,试验组在对照组基础上于术后肠内营养开始日起每日行艾灸治疗30 min。观察两组患者喂养不耐受发生率、肠内营养达标率、肠内营养耐受性评分、首次肛门排气排便时间、血浆D-乳酸、TNF-α水平、CRP。结果 试验组喂养不耐受发生率[腹胀和/或腹痛(17.91%)、恶心和/或呕吐(26.87%)、腹泻(8.96%)]、肠内营养耐受性评分(4.35±1.98)分均低于对照组,肠内营养达标率[(90.12±9.88)%]高于对照组,治疗后两组TNF-α(6.42±1.97)pg/ml、CRP(29.98±9.79)mg/L、D-乳酸水平(4.37±1.27)mmol/L均低于治疗前,且试验组TNF-α、CRP、D-乳酸水平均低于对照组,试验组患者首次排气时间(64.47±19.96)h、排便时间(76.42±15.14)h、肠鸣音恢复时间(58.63±12.93)h与对照组比较均缩短,差异具有统计学意义(P＜0.05)。结论 艾灸可改善胃癌根治术后早期喂养不耐受症状,抑制机体炎症因子释放,且对肠道黏膜修复具有促进作用。
Abstract
Objective To explore the effect of moxibustion on early feeding tolerance and the levels of hypersensitive C-reactive protein (CRP), tumor necrosis factor (TNF)-α, and plasma D-lactic acid in patients after radical gastrectomy for gastric cancer, and to provide evidence for the implementation of enteral nutrition after radical gastrectomy for gastric cancer. Method A total of 140 patients who underwent radical gastrectomy for gastric cancer in our hospital from April 2023 to June 2025 were selected and randomly divided into a control group (70 cases, excluding 3 cases) and an experimental group (70 cases, excluding 2 cases and dropping out 1 case) using a random number table. The control group received routine postoperative care and early enteral nutrition treatment after radical gastrectomy for gastric cancer, while the experimental group received moxibustion treatment for 30 minutes daily starting from the day of enteral nutrition in addition to the treatment of the control group. The incidence of feeding intolerance (abdominal distension and/or abdominal pain, nausea and/or vomiting, diarrhea), enteral nutrition tolerance score, enteral nutrition compliance rate, time to first anal exhaust and defecation, plasma D-lactic acid, TNF-α, and CRP levels were observed in both groups. Result The incidence of feeding intolerance and enteral nutrition tolerance score (4.35 ± 1.98) in the experimental group were lower than those in the control group, and the enteral nutrition compliance rate (90.12% ± 9.88%) was higher than that in the control group. After treatment, the levels of TNF-α (6.42 ± 1.97) pg/ml, CRP (29.98 ± 9.79) mg/L, and D-lactic acid (4.37 ± 1.27) mmol/L in both groups were lower than those before treatment, and the levels of TNF-α, CRP, and D-lactic acid in the experimental group were lower than those in the control group. The time to first exhaust (64.47 ± 19.96) h, defecation time (76.42 ± 15.14) h, and recovery time of bowel sounds (58.63 ± 12.93) h in the experimental group were shorter than those in the control group, and the differences were statistically significant (P < 0.05). Conclusion Moxibustion can improve early feeding intolerance symptoms after radical gastrectomy for gastric cancer, inhibit the release of inflammatory factors in the body, and promote the repair of intestinal mucosa.
关键词
艾灸 /
肠内营养耐受性 /
炎症因子 /
肠黏膜屏障 /
胃癌根治术
Key words
Moxibustion /
Enteral nutrition tolerance /
Inflammatory factors /
Intestinal mucosal barrier /
Radical gastrectomy for gastric cancer
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