Observation On Effect Of Integrated Traditional Chinese And Western Medicine In Treating Patients Of Paralytic Ileus With Multiple Myeloma After Using Bortezomib

Objectives By integrated traditional Chinese and Western medicine to treat paralytic ileus (Qi stagnation type) with multiple myeloma patients after using bortezomib. On the basis of conventional western medicine treatment, retention enema with modified rhubarb and aconite decoction based on syndrome differentiation. Symptoms before and after the treatment in two groups, the bowel sounds recovery time, the first flatus and defecation time, and upright abdominal X-rays and other observation indicators were analyzed. To discuss the pathogenesis of paralytic ileus induced by bortezomib of myeloma patients, then to discuss the clinical efficacy and mechanism of modified rhubarb and aconite decoction on paralytic ileus (Qi stagnation type) caused by bortezomib. To observe the superiority of combining traditional Chinese and western medicine treatment on the disease and provide the basis for clinical treatment.Methods Selected57patients with multiple myeloma from May2011to May2013at the Institute of Hematology appeared abdominal pain, distention, without flatus and other symptoms after using bortezomib-based chemotherapy and diagnosed as paralytic ileus. All patients were randomly divided into treatment group and control group. There were no significant differences in age, gender, myeloma protein M, the onset symptoms and signs, etc., which were comparable (P>0.05). All patients received conventional western medicine treatment:forbidding food and drink, effective gastrointestinal decompression, anal exsufflation; rehydration, supplying enough calories, correcting water-electrolyte and acid-base balance; acid suppression, spasmolysis, and alleviating pain; application of antibiotics to prevent infection when necessary; Monitoring routine blood, albumin and etc., transfusion of suspension red blood cells, granulocyte colony-stimulating factors increasing leukocyte, albumin infusion and other treatment when necessary, on the base of conventional western medicine therapy, all29patients in treatment group were given retention enema with modified rhubarb and aconite decoction based on syndrome differentiation. Take one dose of the herb particles mixed with300ml warm water daily,150ml for once, Q12h..While the control group were given0.2%soft soap solution for retention enema Q12h. Two groups were observed for7days. By observing and comparing the two groups’indicators differences of symptoms, the bowel sounds recovery time, the first flatus and defecation time and upright abdominal X-rays and other observation indicators before and after treatment, analysed the prescription retention enema clinical efficacy on the treatment of paralytic ileus (Qi stagnation type) patients with multiple myeloma after using bortezomib.Restult The treatment group of patients recovered in15cases accounted for51.72%;9cases markedly accounting for31.03%;3cases, accounting for10.34%;2Patient, accounting for6.90%;the total effective rate was93.1%;the control group,6patients recovered cases, accounting for21.43%; markedly effective in5cases, accounting for17.86%;effective in10cases, accounting for35.71%;7cases, accounting for25.00%; the total effective rate was75.00%.All the recovery time of bowel sounds restore, the anal first exhaust time, the first defecation time and treatment time were significantly different.(P<0.05). The treatment group improved faster than the control group. All the tests of blood count, electrolytes and heart, liver and kidney function didn’t appear significant side effects.Conclusions Through retention enema with modified rhubarb and aconite decoction based on syndrome differentiation combined with conventional western medicine treatment, bortezomib-induced paralytic ileus patients with multiple myeloma Acquired very satisfactory results, alleviated the suffering of patients, shorten the disease course. And herbs retention enema were operated conveniently, non-invasive, it effected on the gut directly without toxic side effects. It was a kind of "green" and tolerance therapy adapted to a wide populations, especially for frail or elderly patients who neither tolerate nor suitable for surgery.