| Background and objective:colorectal cancer is one of the most common malignant tumors in the world.The incidence rate has been increased yearly in China. Surgery remains the only effectively curative means nowadays. In recent years,with the increased application of surgery, patients'OS(Overall Survival) has been extended,as well as their quality of life has been improved. However, symptoms such as constipation, defecate difficulty, increased frequency of defecation, pressing feeling and endless feeling along with defecation, diarrhea and incontinence caused by defecation dysfunction have been seriously affected patients with their social lives and mental states, brought great stresses to the patient's daily life. Weaken their confidence of recovery, reduced their degrees of adaptability. Modern medicine pays less attention to this kind of situation, the intervention methods and the curative effects are limited, while traditional Chinese Medicine has played an irreplaceable role in this area. Our research observed the effect of TCM in treating defecation dysfunction in postoperative patients with colorectal cancer.Hoping to provide a more comprehensive and systematic observation and evaluation combined with internationally accepted questionnaire table on the patient's symptoms related to defecation, defecation function and quality of life, offer a theoretical basis and clinical guidance for traditional Chinese Medicine in treating defecation dysfunction.Methods:Postoperative patients with colorectal cancer were enrolled in this study. We surveyed the defecation symptoms through questionnaires and detected the defecation function by the international LARSS amount, QOL was evaluated with QLQ-C30, and QLQ-CR38,using spss21.0 statistical software to analyze horizontal frequency number distribution, chi square test and non parametric Wilcoxon rank sum test and other statistical analysis.Research results:1.General information:A total of 67 cases of colorectal cancer patients were enrolled, the proportion of male and female were 41:26, with an average age of 54.97±12.42 years old.14 cases were 65 years old or older than that,while 53 cases were under 65 years old. There were 35 colon cancer patients,32 rectal cancer patients.All of them were adenocarcinoid,with 40 cases of moderately differentiated,6 cases of poorly differentiated,4 cases of moderately and poorly differentiated,11 cases of well differentiation,6 cases of moderately and well differentiated. We classified these 67 patients with different treatment periods.32 cases had already finished radiotherapy or chemotherapy,17 cases were undergoing these treatment,and 18 cases were free of that. We also divided our patients into 3 types.17 cases of constipation type,48 cases of diarrhea type, and 2 cases of alternative type according to the Bristol defecation character.2.Clinical features:The statistic shows that, not only constipation and diarrhea, pressing feeling and endless feeling along with defecation may cause even more trouble with a higher incidence.Rates of pressing feeling,urgency feeling and bearing feeling were much higher among rectal cancer patients, though other symptoms showed no significant difference between rectal cancer patients and colon cancer patients.Patients of constipation type always followed with defecation difficulty. Constipation,diarrhea, anus and rectum pain showed a significant difference in different treating stages.More constipation,anus and rectum pain than diarrhea occurred in patients who were undergoing radiotherapy or chemotherapy.Most of the 67 cases of patients were qi deficiency syndrome,yang deficiency syndrome,phlegm dampness syndrome,qi stagnation syndrome and heat toxin syndrome.3.Therapeutic evaluation:After 3 months of traditional Chinese Medicine treatment, the stool properties of 67 cases were improved significantly, defecation related symptoms were obviously relieved, patients' satisfaction of defecation process were apparently increased as well.As to the LARSS score,10 cases changed from mild ARS to no ARS.16 cases turned into mild ARS from major ARS.Surprisingly,21 major ARS cases converged into no ARS. Their quality of life were significant improved meanwhile.Conclusion:1.Symptoms such as urgency feeling and endless feeling along with defecation,diarrhea,feeling,defecate difficulty,pressing feeling,constipation and pain have been seriously affected postoperative patients.Urgency,awareness and pressing feelings are most in common among rectal cancer patients.2.Postoperative patients with colorectal cancer showed more complicated syndrome,mixed with excessive pattern and deficiency pattern,mainly include qi deficiency syndrome and yang deficiency syndrome, as well as phlegm dampness syndrome,qi stagnation syndrome and heat toxin syndrome. The core syndrome of this kind were remained toxicity,qi deficiency,and qi in-regulate.A good combination of disease,syndrome and symptom differentiation would insure a good efficacy.3. Traditional Chinese Medicine shows great efficacy in treating postoperative colorectal cancer patients with defecation dysfunction.It was effective not only in treating defecation related symptoms,but also in improving their QOL... |
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