Observation Of Effect Of Moxa Wick Moxibustion Combined With Rapid Rehabilitation Concept On Gastrointestinal Function Recovery After Colorectal Cancer Operation

ObjectiveWith the rapid rehabilitation concept(ERAS),to observe the curative effect of moxibustion with moxa on bilateral Zusanli,Sanyinjiao and Shangjuxu on postoperative gastrointestinal function recovery after laparoscopic radical resection of colorectal cancer.MethodsA single-center,prospective,simple randomized controlled trial was used to treat patients with colorectal cancer who underwent laparoscopic surgery at the Department of Gastrointestinal Surgery and the Department of Colorectal Surgery,Guangdong Provincial Hospital of Chinese Medicine from November 30,2020 to February 10,2021(n=70),grouped by simple randomization method,divided into control group(conventional EARS management,n=35)and study group(conventional EARS management+moxibustion treatment,n=35).Baseline data including gender,age,BMI,previous history of abdominal surgery,complicated underlying disease,operative time,intraoperative blood loss,ASA grade,surgical method,and tumor site were collected and recorded.The main efficacy evaluation indexes were the first postoperative exhaust and defecation time.Secondary efficacy evaluation indexes were the first postoperative full flow time,postoperative hospital stay,the incidence of early postoperative complications such as intestinal obstruction,lymphatic leakage and urinary retention,and the incidence of adverse reactions such as nausea vomiting and abdominal distension.The safety evaluation indexes were the occurrence of adverse events related to the treatment of wick moxibustion,such as blisters,scalds and dizzy moxibustion,as well as the results of blood routine tests,liver and kidney functions,and electrocardiogram.The statistical methods used Fisher exact probability method,t test and Mann-Whitney test.ResultsA total of 70 patients were included in this study,including 35 in the control group and 35 in the study group.There was no statistical significance between the two groups in terms of gender,age,BMI,previous history of abdominal surgery,presence or absence of complicated diseases,operative time,intraoperative blood loss.ASA grade,surgical method and tumor site.In the study group and the control group,the first postoperative exhaust time(27.9±15.5h vs.34.2±19.1h,P=0.037)and the first defecation time(44.7±21.1h vs.59.4±35.7h,P=0.037)were shortened,and the difference was statistically significant.There was no significant difference in the postoperative time of full flow diet(34.3(20.3.44.8)h vs.38.9(20.4.44.7)h[M(P25,P75)],the length of postoperative hospital stay(5.6±1.9 d vs.5.6±2.1 d.P=0.856),the incidence of early postoperative complications(2.9%vs.5.7%.P=1.000),and the incidence of postoperative gastrointestinal dysfunction(22.9%vs.17.1%,P=0.550).During the clinical observation,1 case of subjects in the study group developed mild blisters which were not treated,while the other patients did not develop blisters,burns,dizzy and moxibustion related adverse events of wick moxibustion treatment.The results of postoperative physical and chemical tests,such as blood routine,inflammatory indexes,liver and kidney function,and electrocardiogram of 70 subjects showed no obvious abnormal changes during the clinical observation period.Subgroup analysis was carried out on the age,operation time.The results showed that age and operation time were correlated with the time of first postoperative exhaust and defecation.The older the age and the longer the operation time,the longer the time of first postoperative exhaust and defecation.The first postoperative exhaust and defecation time of the study group was shorter than that of the control group in different age groups and different operation time,but there were no statistical difference except for that the operating time of>3 h group in the term of first time defecation after surgery(P=0.015).Subgroup analysis was performed for patients with a history of abdominal surgery.The result showed that patients with previous abdominal surgery had longer time of first postoperative exhaust and defecation.After excluding the patients with a history of abdominal surgery,the postoperative exhaust and defecation time of the study group were still shorter than that of the control group,but there was no statistical difference between the two groups.Conclusion1.Perioperative application ERAS management with postoperative moxa wick moxibustion on bilateral Zusanli,Sanyinjiao,Shangjuxu may promote the recovery of gastrointestinal function in patients with colorectal cancer laparoscopic surgery,which shows the certain effectiveness and safety,providing certain clinical research basis of combining traditional Chinese and western medicine to promote rapid rehabilitation.2.Age.operation time,and previous history of abdominal surgery have a certain influence on the recovery of gastrointestinal function after surgery.The older the patient,the longer the operation time and the history of abdominal surgery,the slower the postoperative recovery of gastrointestinal function may be.