| Objective:To evaluate the clinical efficacy of periumbilical hot compress with Modified Simo Decoction for relieving abdominal distension with qi stagnation in patients with primary liver cancer(PLC)by observing the changes in the abdominal distension-related TCM symptoms scores,bowel sounds,bowel movement and KPS score pre-and post-treatment,so as to provide evidences for clinical application of periumbilical hot compress with Modified Simo Decoction in abdominal distension in PLC.Methods:Ninety PLC patients with abdominal distension with qi stagnation(qi tympanites)who were admitted to Department of Liver Surgery,Xiamen Hospital of Traditional Chinese Medicine from January 2017 to October 2017 and met the eligibility criteria were selected as the study subjects,and were randomly assigned to the treatment group or control group each including 45 patients.Both groups received the general treatments including liver protection,immune enhancement,antiviral therapy,albumin,and dieresis,etc.;in addition to these treatments,the treatment group received periumbilical hot compress with the modified TCM prescription Simo Decoction concocted with hot vinegar,and the control group received periumbilical hot compress with the placebo using the same method.Before and after treatment,patients in both groups were assessed for the primary symptoms scores for abdominal distension with qi stagnation based on the symptoms grading scale for PLC.The following data were recorded:general patient characteristics(age,sex,pre-treatment distribution of symptoms scores);pre-and post-treatment TCM symptoms scores(total and for each symptom)and their changes;pre-and post-treatment numbers of bowel sounds and bowel movements and their changes;and pre-and post-treatment KPS scores.Statistical analysis was performed on these data using SPSS 18.0 software.Results:1.Comparison of pre-and post-treatment total symptoms score in the two groups(1)At D4 and D8,there were no significant changes from pre-treatment in total symptoms score in the control group(P>0.05),and statistically significant changes from pre-treatment in total symptoms score in the treatment group(P<0.01).(2)There were statistically significant differences between the two groups in changes from pre-treatment in total symptoms score at D4 and D8(P<0.01).2.Comparison of pre-and post-treatment scores for each symptom in the two groups(1)In the control group,there were statistically significant changes from pre-treatment in the scores for abdominal distension and belching at D8(P<0.05),and in scores for distress in epigastrium at D4 and D8(P<0.05);there were no statistically significant changes from pre-treatment in the scores for abdominal distension or belching at D4(P>0.05),or in the scores for anorexia,low food intake or nausea and vomiting at D4 or D8(P>0.05).(2)In the treatment group,there were statistically significant changes from pre-treatment in the scores for abdominal distension,low food intake and distress in epigastrium at D4 and D8(P<0.01),and no statistically significant changes from pre-treatment in the scores for anorexia,belching or nausea and vomiting at D4 or D8(P>0.05).(3)Comparison between the two groups of changes in scores for each symptom pre-and post-treatment:There were statistically significant differences between the two groups in changes in scores for abdominal distension and distress in epigastrium at D4 and D8(P<0.01),and in score for belching at D8(P<0.05);there were no statistically significant differences between the two groups in changes in scores for anorexia,low food intake or nausea and vomiting(P>0.05).3.Comparison of pre-and post-treatment numbers of bowel sounds in the two groups(1)There were no statistically significant changes from pre-treatment in the first 4 or last 4 days of treatment in the control group(P>0.05),and statistically significant changes from pre-treatment in the first 4 and last 4 days of treatment in the treatment group(P<0.01).(2)There was statistically significant difference between the two groups in change from the first 4 to the last 4 days of treatment in number of bowel sounds(P<0.01).4.Comparison of pre-and post-treatment numbers of bowel movements in the two groups(1)In the control group,there was no statistically significant change from pre-treatment in number of bowel movements in the first 4 days of treatment(P>0.05),and statistically significant change from pre-treatment in number of bowel movements in the last 4 days of treatment(P<0.05).(2)In the treatment group,there were statistically significant changes from pre-treatment in the first 4 and last 4 days of treatment(P<0.05).(3)There was statistically significant difference between the two groups in change from the first 4 to the last 4 days of treatment in number of bowel movements(P<0.05).5.Comparison of pre-and post-treatment total effective rates in the two groups The total effective rate in terms of improvement in symptoms scores pre-and post-treatment was 84.4%in the treatment group and 53.3%in the control group,showing statistically significant difference between the two groups upon X2 test(P<0.01).6.Comparison of pre-and post-treatment KPS scores in the two groupsThere were no statistically significant changes in KPS scores pre-and post-treatment in either group(P>0.05).Conclusions:1.Periumbilical hot compress with Modified Simo Decoction significantly relieved the clinical symptoms of abdominal distension with qi stagnation,primarily abdominal distension and distress in epigastriumin,in patients with PLC;there were also varying extents of improvements in the symptoms anorexia,low food intake and belching pre-and post-treatment;in addition,the treatment group was significantly superior over the control group in total effective rate;periumbilical hot compress with Modified Simo Decoction could therefore relieve the symptoms of abdominal distension and reduce distress for patients with PLC,and reduce financial burden on patients' families.2.There were no significant changes in KPS score pre-and post-treatment in either group,nor were there statistically significant differences between the two groups in KPS score,indicating that periumbilical hot compress with Modified Simo Decoction might not improve the overall performance of patients with PLC. |
PDF Full Text Request