Randomized Clinical Trial Comparing Efficacy of Simo Decoction and Acupuncture or Chewing Gum Alone on Postoperative Ileus in Patients With Hepatocellular Carcinoma After Hepatectomy.
Randomized Clinical Trial Comparing Efficacy of Simo Decoction and Acupuncture or Chewing Gum Alone on Postoperative Ileus in Patients With Hepatocellular Carcinoma After Hepatectomy.
复制标题
比较四摩汤与单独针灸或嚼口香糖对肝细胞癌肝切除术后患者术后肠梗阻疗效的随机临床试验。
DOI：
10.1097/md.0000000000001968
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发表时间：
2015-11
期刊：
影响因子：
1.6
通讯作者：
Li LQ
中科院分区：
文献类型：
--
作者：
You XM;Mo XS;Ma L;Zhong JH;Qin HG;Lu Z;Xiang BD;Wu FX;Zhao XH;Tang J;Pang YH;Chen J;Li LQ
比较四磨汤配合针刺足三里穴与单纯嚼口香糖治疗肝癌切除术后肠梗阻的疗效。术后肠梗阻是肝切除术后常见的并发症，肠功能恢复延迟，住院时间延长。研究表明，嚼口香糖可以减少术后肠梗阻; SMD和针灸足三里穴位在中国长期以来一直被用来促进排便。2015年1月至2015年8月期间接受肝切除术的原发性HCC患者随机接受SMD和针灸（n = 55）或口香糖（n = 53）或无干预（n = 54），从术后第1天开始，持续连续6天或直至排气。 主要终点为术后肠梗阻发生率和住院时间;次要终点为手术并发症。SMD+针刺组和咀嚼口香糖组的首次排气、排气和排便时间显著短于未干预组（均P <0.05）。 SMD和针灸联合组的住院时间（平均14.0 d，SD 4.9）显著短于无干预组（平均16.5 d，SD 6.8; P = 0.014），而口香糖组（平均14.7，SD 6.2）和无干预组（P = 0.147）的住院时间相似。 两个干预组中I级和II级并发症的发生率略低于无干预组。SMD联合针刺治疗肝癌术后肠梗阻的发生率低，住院时间短。嚼口香糖也可以减少肠梗阻的发生，但似乎不影响住院时间。（Clinicaltrials.gov注册号：NCT 02438436。）
To compare the efficacy of simo decoction (SMD) combined with acupuncture at the tsusanli acupoint or chewing gum alone for treating postoperative ileus in patients with hepatocellular carcinoma (HCC) after hepatectomy. In postoperative ileus, a frequent complication following hepatectomy, bowel function recovery is delayed, which increases length of hospital stay. Studies suggest that chewing gum may reduce postoperative ileus; SMD and acupuncture at the tsusanli acupoint have long been used in China to promote bowel movement. Patients with primary HCC undergoing hepatectomy between January 2015 and August 2015 were randomized to receive SMD and acupuncture (n = 55) or chewing gum (n = 53) or no intervention (n = 54) starting on postoperative day 1 and continuing for 6 consecutive days or until flatus. Primary endpoints were occurrence of postoperative ileus and length of hospital stay; secondary endpoints were surgical complications. Groups treated with SMD and acupuncture or with chewing gum experienced significantly shorter time to first peristalsis, flatus, and defecation than the no-intervention group (all P < 0.05). Hospital stay was significantly shorter in the combined SMD and acupuncture group (mean 14.0 d, SD 4.9) than in the no-intervention group (mean 16.5 d, SD 6.8; P = 0.014), while length of stay was similar between the chewing gum group (mean 14.7, SD 6.2) and the no-intervention group (P = 0.147). Incidence of grades I and II complications was slightly lower in both intervention groups than in the no-intervention group. The combination of SMD and acupuncture may reduce incidence of postoperative ileus and shorten hospital stay in HCC patients after hepatectomy. Chewing gum may also reduce incidence of ileus but does not appear to affect hospital stay. (Clinicaltrials.gov registration number: NCT02438436.)