关键词: 结直肠癌根治术, 胃肠功能, I-FEED评分, 术后胃肠功能障碍, 益气导滞方

Abstract: Objective To observe the effect of the Yiqidaozhi decoction(YQDZ)on the postoperative intestinal recovery of patients who had undergone radical resection for colorectal cancer,as assessed using the Intake, Nausea, Vomiting, Bloating and Duration of Symptoms(I-FEED)scoring system. Methods A total of 114 colorectal cancer patients who underwent surgery between January 2021 and December 2022 were enrolled in the study and randomly divided into two groups: intervention group(n=57)and control group(n=57). The randomisation process was conducted using a random number allocation method. Both groups received perioperative management of enhanced recovery after surgery(ERAS). The intervention group ingested 100 mL of a concentrated solution of YQDZ, while the control group received 100 mL of an isocaloric solution of water. The present study was conducted from postoperative days 1-3. Postoperative I-FEED scores, intestinal function recovery indicators(times of bowel sound recovery, first flatus, first defecation, first oral intake and semi-liquid diet resumption, and postoperative hospital stay), gastrointestinal hormone levels(serum gastrin and motilin), inflammatory markers(CRP, IL-1β, IL-2, IL-6, TNF-α, IFN-γ), and postoperative complications. The statistical analysis of the data was conducted using SPSS 27.0. Results The YQDZ group demonstrated significantly superior I-FEED scores in the domains of intake(Z=-2.196, P=0.028), nausea(Z=-2.068, P=0.039), bloating(Z=-2.293, P=0.022)and symptom duration(Z=-2.538, P=0.011)when compared to the control group. There was a statistically significant difference in the recovery of gastrointestinal function between the two groups(Z=-2.153, P=0.031). The times of bowel sound recovery, first flatus, first defecation and semi-liquid diet resumption were all shortened in the intervention group(P<0.05). The duration of hospitalisation following surgery was found to be significantly longer in the YQDZ group(P<0.05). On the third day following the operation, the serum levels of gastrin(Z=7.299, P<0.05)and motilin(Z=2.717, P=0.008)were elevated in the intervention group, while the levels of CRP(Z=-2.581, P=0.010)and IL-6(Z=-3.678, P<0.05)were reduced. No statistically significant difference in postoperative complications was observed between the two groups(P=0.788). Conclusion The YQDZ decoction has been demonstrated to be both safe and effective in promoting postoperative intestinal function recovery and reducing gastrointestinal dysfunction in colorectal cancer patients following radical resection. The mechanism may be associated with the regulation of gastrointestinal hormone secretion and the inhibition of postoperative inflammation.

Key words: Radical resection of colorectal cancer, Gastrointestinal function, I-FEED score, Postoperative gastrointestinal dysfunction, Yiqidaozhi Decoction