| There are three parts of this paper:literature review,meta-analysis,and clinical observation.This paper exponded the understanding of low anterior resection syndrome in modern medicine and traditional Chinese medicine,evaluated the treatment efficacy of TCM and integrated traditional Chinese and western medicine of LARS,and explored the clinical efficacy of thumb-tack needle in the treatment of LARS.1.Literature reviewIn this study,we collected and read the literatures related to LARS in CNKI,PubMed and other databases,and summarized the research progress of the understanding,etiology and treatment of LARS in modern medicine and TCM.2.Meta analysisObjective:To systematically evaluate the effcacy of TCM or integrated traditional Chinese and western medicine of LARS.Method:7 databases including CNKI,WF,VIP,Sinomed,Pubmed,Web of Science and Cochrane library were searched for clinical randomized controlled trials of TCM and integrated Chinese and western medicine by computer.RevMan software were used for meta-analysis and shapes drawing.Results:Retrieval and screening results:593 articles were retrieved,and 15 were finally included,with a total of 819 cases.Meta analysis results:TCM:?Clinical effective rate:RR=1.38,95%CI[1.20,1.59],P<0.00001.?Xu Zhongfa scale:RR=1.87,95%CI[1.30,2.69],P<0.00001.?Recurrence rate:RR=0.20,95%CI[0.05,0.87],P=0.03.Integrated traditional Chinese and western medicine:?Clinical effective rate:RR=1.26,95%CI[1.11,1.42],P=0.0003.?Xu Zhongfa scale total points:MD=1.91,95%CI[1.29,2.53],P<0.00001.?LARS scale:MD=-4.46,95%CI[-6.20,-2.72],P<0.00001.?QLQ-C30 Scale:physical function,MD=14.69,95%CI[4.27,25.11],P=0.006;role function,MD=12.23,95%CI[7.20,17.26],P<0.00001;emotional function,MD=11.24,95%CI[6.13,16.35],P<0.0001;cognitive function,MD=10.55,95%CI[5.50,15.60],P<0.0001;social function,MD=14.79,95%CI[12.66,16.93],P<0.00001;overall health area,MD=8.37,95%CI[4.79,11.96],P<0.00001.?Recurrence rate:RR=0.60,95%CI[0.18,2.03],P=0.41.Descriptive analysis results:TCM:?Anal rectal pressure:1 article,test group:ARP(10.02 ± 2.33),control group:ARP(8.12± 2.44)kPa,(P=0.0029<0.05).?Adverse reactions:1 article,test group:6.67%,control group:40%,(P=0.031<0.05).Integrated traditional Chinese and western medicine:?Excellent rate of Xu Zhongfa scale:1 article,test group:85.71%,control group:57.14%,(P=0.008<0.05).?Anal rectal pressure:1 article,test group:ARP(34.26±6.41)mmHg,control group:ARP(31.72±5.83)mmHg,(P<0.05).?Adverse reactions:1 article,test group:6.67%,control group:10%,(P=0.64>0.05).Conclusion:The treatment of TCM or integrated Chinese and western medicine may have good efficacy,which can relieve the clinical symptoms,improve intestinal function and patients' quality of life.But the conclusion still needs further evidence to support.3.Clinical observationObjective:To observe the effect of thumb-tack needles on low anterior resection syndrome of rectal cancer.Methods:Thumb-tack needles were used to treat low rectal cancer resection syndrome of rectal cancer.Efficacy and safety were evaluated before and after treatment and during follow-up.Results:After treatment,the LARS grade,LARS score,air leakage,defecation frequency,and defecation urgency scores decreased compared with those before treatment(P<0.05),and there were no statistical difference in scores of stool leakage before and after treatment(P<0.05).There were no statistical difference between scores at follow-up and before treatment(P<0.05),and no statistical difference between adverse reactions before and after treatment(P<0.05).Conclusion:Thumb-tack needles in the treatment of low anterior resection syndrome of rectal cancer can reduce the LARS scale scores,improve the quality of patients' life and have high safety.The long-term effect is not good after once treatment. |
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