| [Background]:Postsurgical gastroparesis syndrome(PGS)is a disorder of gastric motility dysfunction whose main symptom is delayed gastric emptying caused by non-mechanical obstruction factors after abdominal surgery,and is also a postoperative early complication distressing patients with abdominal surgery,especially tumor patients.There are varies of common western treatments for PGS at present,however,they are contradictory and effective methods with fast improvement are still expected Multiple treatments for PGS exist in TCM,showing certain advantage.But unfortunately,the amount of research samples is limited.And oral administration may aggravate the burden on gastric intestine and gastric symptoms like nausea and vomiting,which may do harm to patient compliance,besides,many bitter and cold medicine in the prescription may cause stomach qi damage and physicians should also be cautious when treating PGS;External therapies of TCM,such as acupuncture,external application of Chinese medicine,enteroclysis,have efficacy on PGS,but the efficacy is limited.As a result,it is of significant meaning to combine effective external therapy to treat PGS,to explore and complete present treatment model and to take full advantage of TCM.[Objective]:To provide PGS patients with intervention of acupuncture combined with acupoint application of Chinese herb and make a comparison between conventional western medicine and TCM with prospective and random control research design,evaluating the efficacy and feature of TCM,and to explore external therapy of TCM.[Method]:Totally 106 cases of PGS patients who met with the standard hospitalized in Beijing Hospital of TCM and Cancer Hospital Chinese Academy of Medical Sciences during July 1st 2013-August 30th 2016 were randomized into a treatment group(acupuncture and acupoint application of Chinese herb)and a control group(conventional treatment)in accordance with the random number table method.The two groups were given the same basic western medicine treatment:control group with extra Metoclopramide Dihydrochloride intramuscular injection 10mg each time,twice per day;treatment group with extra acupuncture and acupoint application of Chinese herb,through modified Old 10-needles with even reinforcing-reducing method,20min each time,once per day,and hospital-made Tong Fu application on Shenque point and Yongquan point of both feet,4-6h of treatment before taking off,once per day.Indicators including PGS remission rate,gastric drainage volume,time of gastric tube pulled out,symptom score and physical condition score of the 7 th,14 th,21st and 30 th day of treatment were observed and counted.The efficacy of the two groups were compared and evaluated,and external TCM therapy of PGS were concluded and improved.[Result]:Patients in the treatment group enjoyed favorable efficacy with safety.1.PGS remission rate:on the 7 th,14th,21st and 30st day of treatment,the PGS remission rates were 98.11%and 25.49%,98.11%and 60.78%,100.00%and 86.27%,100.00%and 90.20%separately,treatment group significantly higher than that of the control group.The difference on the 7th,14th,21st day was statistically significant(P<0.01),so did that of the 30th day(P=0.026).2.PGS remission:on the 7 th,14 th,and 21st day of treatment,the PGS remission in the treatment group was better than that of the control group,and the difference between the two groups had statistical significance(P?0.01),the diference on the 30th day had no statistical significance(P=0.079).3.Gastric drainage volume:after the 3rd day of treatment,significant difference between the 2 groups appeared,treatment group largely lower than that of the other group(P<0.01).4.Time of gastric tube pulled out,starting from inserting,the difference between the two groups showed significant difference(P =0.017),treatment group shorter.And the difference had no statistical significant.(P =0.298).5.Symptom score:on the 7st,14 th,and 21 st day of treatment,the difference between the two groups showed significantly,the treatment group greatly lower than that of the control group(P<0.01).6.Physical condition score:on the 7th,14th,and 21st day of treatment,the difference between the two groups showed significantly,the treatment group greatly higher than that of the control group(P<0.01).7.Nutrition indicators:only potassium ions showed difference between the two groups on the 7th day(P=0.004)while other indicators had no statistical significance(P>0.05).8.Safety:there were no adverse events report in this research,and the clinical examination of main safety indicators including white blood cell,hemoglobin,blood platelet,bilirubin,ALT,GGT,BUN and Cr had no statistical significance(P>0.05).[Conclusion]:Acupuncture(the Old 10-needles)and acupoint application of Chinese herb(Shenque point and Yongquan point)increases the remission rate of PGS,reduces gastric drainage volume,decreases time of inserting gastric tube,releases digestive tract symptoms,improves the life quality,and of good safety. |
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