| Objective：This study investigated the effect of different treatments on defecation function and the distribution of syndrome types in patients with colorectal cancer by questionnaire,a prospective randomized controlled study was conducted to investigate the effect of modified Gegenqinlian decoction on the patients with abnormal bowel function of damp-heat accumulation type after colorectal cancer operation,to observe the change of Symptom Score,score of MSKCC questionnaire and EORCT QLQ-CR30/38 score,and to evaluate the clinical effect of modified Gegenqinlian decoction in the treatment of abnormal defecation function of damp-heat retention type after colorectal cancer operation.Methods:The study was divided into two parts.In the first part,the patients with colorectal cancer were investigated by questionnaire to study the influence of different treatments on the defecation function and the distribution of syndrome types,the data were analyzed by SPSS 26.0 in frequency distribution,independent t test and nonparametric test.In the second part,100 patients with abnormal defecation function of dampness-heat accumulation type were randomly divided into two groups according to the diagnosis of dampness-heat accumulation type and the syndrome differentiation of TCM,the ratio of cases was 1:1,50 cases in treatment group and 50 cases in control group.The dosage regimen:The Test Group was given orally modified Gegenqinlian decoction-free decoction once a day,100 ml in the morning and 100 ml in the evening,and the control group was given orally clostridium butyricum capsules twice a day,3 capsules each time for 3 weeks,the scores of Symptom Score,MSKCC intestinal function questionnaire score and Eorct QLQ-CR30/38 quality of life score were compared between the two groups,SPSS 26.0 was used for frequency distribution,chi-square test,independent sample t-test,non-parametric test and other statistical analysis.Results:①Part One:The incidence of abnormal defecation function:Postoperative(postoperative,postoperative chemotherapy,postoperative radiotherapy and chemotherapy)caused abnormal defecation function as high as 85%.Postoperative radiotherapy and chemotherapy accounted for 84%,postoperative chemotherapy for 83%and postoperative defecation dysfunction for 89%.The incidence of symptoms in abnormal defecation function:After operation(after simple operation,after postoperative radiotherapy and chemotherapy,after postoperative chemotherapy),heavy feeling,defecation,anal drop,defecation times and abnormal stool were the main factors.Among them,the patients after chemotherapy mainly after heavy,defecate hard,anal drop,defecate uncomfortable primarily,after chemotherapy and radiotherapy patients mainly after heavy,defecate hard,anal drop,defecate abnormal mainly,simple postoperative anal dropsy,abnormal stool,abnormal defecation,unpleasant defecation,urgent stool,heavy feeling after the main.Hematochezia and mucilage decreased in different ways compared with untreated.After radiotherapy and chemotherapy,the symptoms of anal drop,burning,pain,back weight,bad defecation and weakness of defecation were aggravated(<0.05),after chemotherapy,the symptoms of abnormal stool,frequent defecation,burning,pain,dropping anus,urgent and heavy defecation,unpleasant defecation and weak defecation were aggravated(<0.05),simple postoperative defecation,abnormal defecation,anal drop,pain,urgent,heavy after defecation,such as symptoms aggravated(<0.05).The distribution of abnormal defecation function:The majority of untreated cases were damp-heat accumulation(61.0%),the frequency of syndrome types was from high to low:damp-heat accumulation(38.0%),deficiency of spleen Qi(32.1%),deficiency of spleen and kidney Yang(19.8%),deficiency of both Qi and blood(5.6%),deficiency of liver and Kidney Yin(2.4%)and stagnation of toxin(2.1%).Among them,simple operation to damp-heat accumulation(48.3%),spleen deficiency QI stagnation(19.4%)mainly.②Part Two:Overall efficacy:The experimental group was better than the control group in improving the stool quality,the feeling of defecation and the overall curative effect(p<0.05).After the treatment,the stool quality,the stool sensation symptom and the total volume score in the two groups were obviously decreased(p<0.05).The overall effective rate was 95.8%in the experimental group and 2.2%in the control group.The overall effective rate was 44.4%in the experimental group.The curative effect of the Experimental Group was better than that of the control group(p<0.05).Symptoms of abnormal bowel function:The Test Group was better than the control group in improving the symptoms such as diarrhea,unpleasant defecation,laborious defecation,sudden death,back weight,anal distension and falling(p<0.05).There was no significant difference in the improvement of constipation,frequency and anal pain between the two groups(p>0.05).After treatment,the scores of symptoms in the test group were significantly lower than those before treatment(p<0.05).In the control group,the scores of diarrhea,constipation,frequency and anal drop were significantly decreased after treatment(p<0.05).There was no significant difference between the two groups in the symptoms of constipation,defecation and pain(p>0.05).MSKCC intestinal function symptom score:The improvement of intestinal function in test group was better than that in control group(p<0.05).After treatment,the scores of intestinal function in both groups were significantly lower than that before treatment(p<0.05).Quality of Life Eorct QLQ-CR30/38 symptom scores:The experimental group was better than the control group in improving the quality of life(p<0.05).After treatment,the incidence of body,role,emotion,cognition,social function,general health,quality of life,urination,gastrointestinal tract,self-cognition,score of defecation function,pain,insomnia,loss of appetite in the experimental group decreased significantly(p<0.05),there was no significant difference in dyspnea,nausea and vomiting,economic difficulty before treatment(p>0.05).The scores of role,cognitive function,general health,quality of life,intestinal tract,self-cognition,defecation function in the control group were significantly decreased after treatment(p<0.05),however,there were no significant differences in the incidences of body,mood,society,urination,dyspnea,pain,fatigue,insomnia,lack of appetite,nausea and vomiting,and economic difficulty(p>0.05).Conclusion:① 85%of patients with colorectal cancer had abnormal defecation function afteroperation(postoperative,postoperative chemotherapy,postoperative radiotherapy andchemotherapy),and 89%of patients had abnormal defecation function only after operation,with anus drop,defecate,defecate is abnormity primarily.Compared with before treatment,the symptoms of anal drop,burning and pain were worse after radiotherapy andchemotherapy,the symptoms of abnormal defecation,frequency and burning were worseafter chemotherapy,and the symptoms of simple postoperative defecation,abnormal defecation and anal drop were worse The proportion of damp-heat Accumulation Syndrome was higher before and after operation.②Modified Gegenqinlian decoction can effectively improve the quality of life of patients with damp-heat accumulation type of colorectal cancer after operation,and improve the intestinal function. |
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