| [Research backgroud]The incidence of malignant tumors of postoperative adhesive intestinal obstruction increase year by year, seriously affects the patients quality of life. Malignant tumor patients after abdominal surgery due to large operation range increased the probability of concurrent adhesive intestinal obstruction, which is a common complication of surgery. For adhesive intestinal obstruction treatment including surgery and nonoperative treatment, conservative treatment, postoperative adhesive intestinal obstruction occurred tumor surgery again, at this moment surgery is difficult, and easy to cause the bowel injury when operation, the probability of recurrence of intestinal obstruction increased significantly, while considering the tumor patients with postoperation constitution and recovery are more difficult, so conservative treatment is more widely applied. Conservative treatment including western medicine and traditional Chinese medicine therapy. Including conventional western medicine treatment such as fasting for solids and liquids, gastrointestinal decompression, nutritional support, anti-infection and so on, as well as the application of somatostatin drugs, etc. has obtained the certain effects. While only with conventional western medicine treatment the time is long, slow recovery; Chinese medicine treatments of postoperative adhesive intestinal obstruction have good curative effect, due to intestinal obstruction in patients with difficulty in feeding and the internal one tends to increase in patients with gastrointestinal burden, some patients can’t tolerate, preliminary clinical study found that the traditional Chinese medicine external treatment (including the patches apply) for treatment of postoperative adhesive intestinal obstruction is a safe, effective and simple applicable treatment. But majority of physicians in the treatment of herb use more will use the whole body of the diagnosis and treatment methods, lacking of local diagnosis and treatment. Mentor found in the early clinical treatment of malignant tumor postoperative adhesive intestinal obstruction local syndrome differentiation for "cold syndrome", she use the "warming Yang and eliminating cold, promoting Qi and bowel-relaxing" principles, with the application of creative "WenYangYiQiTongFu" acupoint sticking, clinically cured many patients with malignant tumor after partial differentiation of type "cold syndrome" adhesive intestinal obstruction patients, the clinical curative effect is distinct.[Research objective]Through clinical research, evaluating "WenYangYiQiTongFu" acupoint sticking to threat postoperative local syndrome differentiation of malignant tumor "cold syndrome" type adhesive intestinal obstruction clinical efficacy and safety, to provid this disease a scientific basis and provide such patients a simple application, safe and effective treatment of traditional Chinese medicine, in order to further clinical promotion, improve the rate of postoperative rapid recovery.[Research methods]This topic includes two parts, the review of literature and the clinical research. The review of literature including the review of traditional Chinese medicine and western medicine, mainly for intestinal obstruction (including malignant tumor postoperative adhesive intestinal obstruction) summarized the understanding and treatment of Chinese and western medicine; The clinical research use forward looking, openness, multicenter clinical design, selection of malignant tumor postoperative local "cold syndrome" type of 50 patients with adhesive intestinal obstruction, with"WenYangYiQiTongFu" acupoint sticking, including lost 5 patients,45 patients completed the experiment and statistical analysis. Compare the stand of before and after the treatment of abdominal plain film, record before and 14 days after treatment in patients with intestinal function recovery and local "cold syndrome" intestinal obstruction of TCM symptom integral, statistical analysis of the results to evaluate the safety index, at the same time for 1 month after treatment for the patient follow-up, to evaluate " WenYangYiQiTongFu" acupoint sticking treatment of malignant tumor postoperative local "cold syndrome" type adhesive obstruction clinical efficacy and safety.[Research results]①Overall curative effect evaluation:according to the intestinal obstruction effect of decision criteria to include 45 patients before and after treatment of intestinal obstruction symptoms, signs, stand abdominal plain film and determine curative effect, after statistical treatment of 10 cases were complete remission (22.2%),17 cases were markedly improved (37.8%),13 cases were valid (28.9%),5 cases were invalid (11.1%), the total effective rate was 88.9%, greater than the conventional western medicine treatment of 60-70%, effective instructions "WenYangYiQiTongFu" acupoint sticking therapy of malignant tumor postoperative local "cold syndrome" type the clinical curative effect of adhesive intestinal obstruction was superior to that of conventional western medicine treatment.②Intestinal functional recovery curative effect evaluation:to include 45 patients before and after treatment of intestinal function recovery, the statistics before and after treatment in patients with the number of air ripple, defecation frequency, times of bowel sound, amount of gastric juice, quantity of vomiting, comparison that P<0.05, differences are highly statistically significant. "WenYangYiQiTongFu" acupoint sticking were applied on postoperative adhesive intestinal obstruction in patients with malignant tumor intestinal function recovery has improved significantly.③Local "cold syndrome" intestinal obstruction of TCM symptoms curative effect evaluation: to include the local "cold syndrome" of 45 patients intestinal obstruction of TCM symptom integral of statistics, the results showed complete response 14 cases (31.1%),14 cases (31.1%) were markedly effective, effective 11 cases (24.5%), invalid in 6 patients (13.3%), the total effective rate was 86.7%. "WenYangYiQiTongFu" acupoint sticking on postoperative local malignant tumor "cold syndrome of TCM symptoms of intestinal obstruction have improved significantly.④Local "cold syndrome" intestinal obstruction symptom integral comparison of traditional Chinese medicine:45 cases of patients before and after treatment to include local "cold syndrome of TCM symptoms of intestinal obstruction" integral comparison, including local skin cold, abdominal pain, abdominal distension, bowel, nausea, vomiting, the frequency of borborygmi and exhaustion when encounter cold. The results of various symptoms before and after the comparison of P< 0.05, were highly significant difference, explain that "WenYangYiQiTongFu" acupoint sticking were applied to the local "cold syndrome" intestinal obstruction of TCM symptoms have improved significantly.⑤KPS score:45 cases of patients before and after treatment to include KPS score of statistics, comparing P= 0.474> 0.05, There was no statistically significant difference, suggesting that "WenYangYiQiTongFu" acupoint sticking were not improve the physical condition of patients with postoperative malignant tumor of local "cold syndrome" intestinal obstructioncould.⑥Safety evaluation:The whole experiment process does not appear in the skin adverse reactions associated with treatment. There are no serious impacts in blood routine, liver and kidney function, plasma levels, electrocardiogram (ecg) level. It explain that "WenYangYiQiTongFu" acupoint sticking on patients with postoperative malignant tumor of local "cold syndrome" intestinal obstruction is a safe and feasible treatment.⑦Follow-up resort:1 month follow-up after treatment,45 cases of 15 cases of patients with effective treatment in patients continue to use after 7 to 14 days in order to consolidate curative effect; Effective 40 cases,2 cases of patients with obstruction in patients with recurrence, recurrence rate was 5%,1 case caused by later systemic chemotherapy,1 case caused by improper diet; Invalid 5 patients after 1 month one case of incomplete obstruction patients become better, the other 4 cases still have different degree of obstruction. We consider it may be because these cases had longer duration of obstruction and heavier completeness obstruction.It explain that "Wen Yang YiQiTongFu" acupoint sticking treat on patients with postoperative malignant tumor of local "cold syndrome" intestinal obstruction has long clinical effect.[Research conclusion]"WenYangYiQiTongFu" acupoint sticking is the treatment of malignant tumor postoperative local "cold syndrome" type adhesive intestinal obstruction effective method, it can obviously improve the symptoms and signs of patients with intestinal obstruction, improve the recommend of abdominal plain film,and improve The local "cold syndrome" intestinal obstruction symptoms of traditional Chinese medicine, and is safe and effective, the recurrence rate is low. Thus it can be used as one of the effective methods of the treatment of malignant tumor postoperative local "cold syndrome" type adhesive intestinal obstruction. |
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