| Objective: To investigate the clinical effect of interventional therapy for patients undergoing thoracoscopic lobectomy with integrated Chinese and Western medicine based on the concept of accelerated recovering after fast track surgery.Methods: Eighty patients with cardiothoracic surgery in department of Cardiothoracic Surgery,Jiangsu Province Hospital on Integrated of Traditional Chinese and Western Medicine from June 2018 to May 2019 were eligible for thoracoscopic lung ablation.They were randomly divided into Western medicine treatment group and integrated traditional Chinese and Western Medicine group,Western medicine treatment group using fast track surgery concept for perioperative related interventions,including: preoperative patient mission and respiratory function training;intraoperative optimization of anesthesia selection and the use of total thoracoscopic operation to reduce surgical stress response;Postoperative multimodal analgesia regimen [intercostal nerve block(INB)+ intravenous controlled analgesia(PCIA)] and rehabilitation exercise.The integrated traditional Chinese and Western Medicine group was treated with fast track surgery and traditional Chinese Medicine,The treatment of auricular acupoints in the integrated traditional Chinese and Western Medicine group was performed from the time of admission to the night before surgery.On the second day after the operation,the self-feeding was resumed.The addition and subtraction of Fuyuan Huoxue Decoction continued until the patient was discharged from the hospital.During the period,the traditional Chinese medicine hot pack was used for external incision(2 times/day).The perioperative routine treatment was the same in both groups.Forty patients in each group were compared,and the pain,rehabilitation and complications of the two groups were compared.The effects of TERA concept on the recovery of patients undergoing thoracoscopic lobectomy were analyzed.Results:The visual analogue scales of pain were(3.15±0.87),(3.12±0.74)and(3.79±0.62)at 24 h,48 h and 72 h after surgery in the integrated Chinese and Western medicine group,and(3.94±0.72),(3.57±0.43)and(4.09±0.28)respectively at 24 h,48 h and 72 h after surgery in the western medicine group.The visual analogue scores of pain 24 h,48 h and 72 h after operation in the integrated Chinese and Western medicine group were significantly lower than those in the western medicine group(P<0.05).There was no statistically significant difference in preoperative CRP and IL-6 between the two groups(P>0.05).24 h,48h and 72 h CRP were(8.43±1.22)mg/L,(7.48±0.81)mg/L,(6.71±0.77)mg/L,respectively,in the integrated Chinese and Western medicine group;24h,48 h and 72 h CRP were(9.93±1.08)mg/L,(8.06±0.82)mg/L and(7.53±0.69)mg/L,respectively,in the western medicine group,compare the differences between groups were statistically significant differences(P < 0.05).After 24 h,48h and 72 h,the CRP levels in the integrated Chinese and Western medicine group were significantly lower than those in the western medicine group(P<0.05).24 h,48h and 72 h IL-6 after operation were(50.12±10.92)pg/ml,(46.28±9.74)pg/ml,(39.92±9.88)pg/ml,(53.90±9.81)pg/ml and(46.48±9.12)pg/ml,respectively,in the integrated Chinese and Western medicine group,24 h,48h and 72 h IL-6 after operation were(58.83±11.74)pg/ml,(53.90±9.81)pg/ml,and(46.48±9.12)pg/ml,respectively,in the western medicine group,comparative differences are statistically significant differences between groups(P < 0.05).The levels of IL-6 in the integrated Chinese and Western medicine group at 24 h,48h and 72 h after operation were significantly lower than those in the western medicine group(P<0.05).The total complication rate was 2.50% in the integrated Chinese and Western medicine treatment group and 7.50% in the Western medicine treatment group.The difference was not statistically significant(P=0.608).The postoperative chest tube indwation time in the integrated Chinese and Western medicine treatment group was(67.91±6.92)h,while that in the western medicine group was(69.74±7.82)h.The postoperative chest tube indwation time got no differences between the two groups(P=0.271).Postoperative drainage volume was(156.38±24.92)ml in the integrated Chinese and Western medicine treatment group and(161.81±28.92)ml in the western medicine treatment group.There was no statistically significant difference in postoperative drainage volume between the two groups(P=0.371).The length of hospitalization in the integrated Chinese and Western medicine treatment group was(8.84±0.92)d,while that in the group of western medicine was(9.08±0.89)d.The length of hospitalization got no difference between the two groups(P=0.239).No patients died during hospitalization in both groups.The operation time of the integrated Chinese and Western medicine treatment group was(109.85±12.81)min,while that of the western medicine group was(110.83±11.92)min,with no significant difference between the two groups(P=0.724).Intraoperative blood loss was(187.92±43.82)ml in the integrated Chinese and Western medicine treatment group and(190.76±44.08)ml in the group of western medicine treatment,and there was no significant difference in intraoperative blood loss between the two groups(P=0.773).Conclusion: In recent years,fast track surgery has been widely used and applied in the surgical treatment of various surgical diseases,and its clinical effect has been affirmed by most research institutes.In the field of thoracic surgery,minimally invasive thoracoscopic techniques fit this concept,and are gradually included in the treatment system for early stage lung cancer and benign lung diseases in the light of the advantages of small trauma,short operation time and quick postoperative recovery.Based on the overall concept,TCM strives to maintain the stability of the human body environment to promote damage repair.Surgery and phlegm,Chinese medicine and righteousness,complement each other,complement each other.This study relies on the characteristics of the pathogenesis of postoperative "right qi deficiency and blood stasis".The treatment of “gasification,stagnation,stagnation and stagnation”,“Yiqi Fuzheng,Huayu Tongluo” will carry out perioperative intervention treatment,combining minimally invasive techniques,rapid rehabilitation techniques and advantages of traditional Chinese medicine.Further improve the clinical efficacy and highlight the concept of “accelerated rehabilitation surgery”.If we can deeply study the specific methods,curative effects and related mechanisms of TCM application in fast track surgery,and integrate Chinese medicine into it,and finally develop a new model of fast track surgery treatment with Chinese characteristics of integrated Chinese and Western medicine,which can further accelerate the postoperative patients with thoracic surgery.The rehabilitation process improves the quality of rehabilitation and has significant social and economic benefits. |
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