Enteroclyster with composite Dachengqi decoction in the treatment of gastroparesis syndromes after resection of esophageal carcinoma or cardiac carcinoma

Aim: To study the feasibility and clinical value of the enteroclyster with composite Dachengqi decoction (CDD) for gastroparesis syndromes after resection of esophageal carcinoma or cardiac carcinoma, which lasts for a long term and affects the functional recovery of patients. Methods: Totally 11 patients with gastroparesis syndromes after resection of esophageal carcinoma or cardiac carcinoma were enrolled from Department of Cardiothoracic Surgery, Affiliated Hospital, Nanjing University of Traditional Chinese Medicine between September 2004 and April 2006, including 6 males and 5 females, mean age of (62.3±10.8) years. CCD was consisted of 10 g rhubarb (last prescription), 5 g sodium sulfate (powder preparation), 10 g immature orange fruit, 20 g magnolia bark, 10 g peach seed, 10 g red peony root and 30 g stir‐baked semen raphani. Metoclopramide Dihydrochloride Injection was produced by Shanghai Harvest Pharmaceutical Co., Ltd (Approval document: H31021522, Product number: 5A08006). All the patients were randomized into: 1 Investigative group (n =6): either gender, mean age of (60.1±10.8) years; 2 Control group (n =5): 3 males and 2 females, mean age of (68.6±5.1) years. They were matched in age and gender constituent ratio, but no statistical difference was found (Xgender2=0.110 3, P =0.739 8; Xage2=3.035 9, P =0.081 4, P > 0.05). Among 5 cases of esophageal carcinoma, there were one for superior segment, 2 for middle piece and 2 for inferior segment. Other 6 cases were cardiac carcinoma. Inclusive criteria: 1 undergo resection of esophageal carcinoma or cardiac carcinoma; 2 in accordance with the diagnosis standard for gastroparesis by the Third International Academindegoc Association of Digestive Endoscope and Gastroenterology; 3 sign the informed consents; 4 in a fair fitness; 5 no application of drugs affecting smooth muscle contraction, such as 654‐2, atropine. Exclusive criteria: 1 intolerant for enteroclyster; 2 loners; 3 patients with diabetes, connective tissue disease or hypothyrosis; 4 complicated with heart, brain, kidney and other serious disease. Investigative group was enteroclystered with 100 mL CDD for 6 days, twice one day. The patients of the control group were injected with Metoclopramide Dihydrochloride intramuscularly. The other treatments were the same in the two groups. Serological gastrin and the times of bowel sound were recorded before and after the different treatments. Besides, the extent of improving the patients' clinical syndromes and clinical effect was also evaluated. Results: Totally 11 patients entered the result analysis. 1 The serological gastrin, times of bowel sound and the clinical syndromes had no statistic difference between the two groups before treatment (P > 0.05). 2 The clinical syndromes had significant difference between the two groups before and after treatment (Z =‐10.5, P < 0.05). 3 The times of bowel sound in the two groups were also significantly different before and after treatment (Z =10.5, P < 0.05). 4 There was significant difference in curative effects of the two groups (investigative group: healing: 83.3%; improved: 16.7%; ineffective: 0; control group: healing: 20%; improved: 40%; ineffective: 40%, Z =4.49, P < 0.05). Conclusion: The enteroclystering with CDD can increases the clinical curative effects effectively in the gastroparesis syndromes after resection of esophageal carcinoma or cardiac carcinoma, and it is better than Metoclopramide Dihydrochloride.