| Gastrointestinal malignant tumor is one of the most common gastrointestinal malignant tumors.Due to the influence of social and economic development,changes in diet structure,environmental alterations,and aging population,the incidence rate and mortality of gastrointestinal malignant tumors are increasing significantly,and most patients are in the advanced stages when first diagnosed.At present,the diagnosis and treatment of gastrointestinal malignant tumors are still based on western medicine.Surgical trauma may have different degrees of inhibition on the gastrointestinal tract,resulting in different degrees of gastrointestinal motility dysfunction(POGD),and even lead to enterogenous infection and secondary multiple organ dysfunction,which seriously threatens the life of patients.The traditional evaluation method is mainly based on the clinical symptoms of patients,such as the recovery of bowel sounds,the disappearance of abdominal distension,no nausea and vomiting,anal exhaust and defecation,gastrointestinal pressure measurement,gastrointestinal hormone measurement,etc.,to evaluate the recovery of gastrointestinal motility of patients after surgery.Its evaluation indicators are relatively scattered,and there is no unified gold standard for evaluating gastrointestinal function in clinical practice at present,which affects the accuracy of evaluation to a certain extent.Traditional Chinese medicine emphasizes that appetite is an important function of the spleen and stomach,and appetite regulation is involved from the brain to the stomach.Based on this,the purpose of this study is to explore the credibility of appetite as an index to evaluate the gastrointestinal function after surgery for gastrointestinal malignant tumors.By adding appetite score to the traditional evaluation method of postoperative gastrointestinal function recovery,the study is to study the correlation between appetite and gastrointestinal function recovery after surgery,and to study the correlation and regularity between appetite and tongue coating in combination with the change of tongue coating of patients after surgery,To explore the scientific and clinical significance of appetite and tongue coating as indicators for evaluating gastrointestinal function after operation of gastrointestinal malignant tumors.Part 1: The Relationship between Appetite Score,Tongue Examination and Traditional Indexes and Postoperative Gastrointestinal Function RecoveryObjective: We aim to study the correlation between appetite and recovery of gastrointestinal function after surgery,and to discuss the significance of appetite score combined with tongue diagnosis and traditional evaluation methods for postoperative rehabilitation of gastrointestinal malignant tumors and guiding clinical treatment.Methods:60 patients who underwent laparoscopic resection of gastrointestinal malignant tumors from December 2021 to December 2022 in the Department of Gastrointestinal Surgery of Shandong Provincial Hospital of Traditional Chinese Medicine were involved in this study,and we selected the samples who met the inclusion and exclusion criteria.Various indicators were included and analyzed,including gender,age,main diagnosis,hospital days,operation name,operation duration,anesthesia method,gastric tube extraction time,anal tube extraction time,first bowel sound time,first exhaust time,first defecation time,bowel sound audio rate(1 day before surgery and 1-7 days after operation),appetite score(1 day before surgery and 1-7 days after operation),and recorded the tongue coating and color of patients 1 day before operation and every morning after operation when fasting.Results:Compared with the appetite score on the first day before operation,the appetite score of patients with gastrointestinal carcinomas decreased significantly on the first day after operation,and gradually increased within one week after operation.Appetite score was positively correlated with other traditional evaluation methods of gastrointestinal function(e.g.recovery of bowel sounds)after operation;The appetite score was negatively correlated with the time of the first bowel sound,the time of the first exhaust,and the time of the first defecation.Yellow and greasy fur,yellow and white greasy fur and thin white fur were common one day before operation,and the appetite score was not more than 6 points;All patients were in a low appetite state within 2 days after operation,and the appetite score was in a medium and low state within 4 days after operation,and in a medium and high appetite state after 6 days after operation.With the improvement of patients’ appetite,the proportion of white greasy fur and yellow greasy fur gradually decreased,and the proportion of thin yellow and white fur increased.The change of tongue color before and after the operation was not obvious,and that pink tongue is the most common.Conclusion: We speculated that appetite score combined with tongue examination can help to evaluate postoperative gastrointestinal function and guide clinical treatment.Part 2: Meta-analysis on the Treatment of POGD in Gastrointestinal Malignant Tumors with Invigorating Spleen and Supplementing Qi MethodObjective: We aim to evaluate the effectiveness and safety of the method of invigorating the spleen and replenishing qi combined with western medicine in the treatment of gastrointestinal malignant tumor POGD,and to provide a theoretical basis for clinical practice.Methods: The Chinese Journal Full-text Database(CJFD),CNKI,WANFANG DATA,VIP,CBM,Embase,Pub Med,Web of Science,Cochrane Library Chinese herbal decoction for gastrointestinal malignant tumors were searched.The retrieval time range is from the establishment of the database to December 31,2020.According to Cochrane’s standard,select the documents that meet the inclusion criteria,extract data,and conduct quality evaluation,and use the Reviewe Manager(Rev Man,version 5.3)software to analyze the relevant data.Results: A total of 404 patients were enrolled in 14 RCTs.The results of meta-analysis showed that the improvement rate of malignancy,vomiting,diarrhea and quality of life in the integrated Chinese and western medicine group were higher than those in the western medicine group(P<0.05).Conclusion: The method of invigorating spleen and replenishing qi combined with western medicine has significant potential effect in the treatment of gastrointestinal malignant tumors,which can improve the POGD of patients with gastrointestinal malignant tumors,and is conducive to improving the quality of life of patients. |
PDF Full Text Request