【目的】观察温针灸对肠造口还纳术后患者肠道菌群及肛门功能的影响。 【方法】将94例行结直肠癌肠造口还纳术的患 者随机分为观察组和对照组，每组各47例，对照组给予术后常规治疗，观察组在对照组治疗的基础上，给予温针灸治疗。 2组均连续治疗2周。治疗2周后，观察2组患者治疗前后肠球菌、大肠埃希菌、乳杆菌、双歧杆菌门水平相对丰度的变化情 况，以及首次排气时间、首次进食时间、住院时间。比较2组患者治疗前后便秘评分量表 （Wexner） 和低位直肠前切除综合征 （LARS） 评分的变化情况，以及肿瘤坏死因子α （TNF-α） 、白细胞介素8 （IL-8） 、C反应蛋白 （CRP） 的变化情况，并评价2组并 发症发生率的情况。 【结果】（1） 观察组首次排气时间、首次进食时间、住院时间均明显少于对照组，差异有统计学意义 （P＜ 0.05） 。 （2） 治疗后，2组患者肠球菌、大肠埃希菌、乳杆菌、双歧杆菌门水平相对丰度均明显改善 （P＜0.05） ，且观察组在改 善肠球菌、大肠埃希菌、乳杆菌、双歧杆菌门水平相对丰度方面明显优于对照组，差异均有统计学意义 （P＜0.05） 。 （3） 治疗 后，2组患者肛门功能Wexner评分、LARS评分均明显改善 （P＜0.05） ，且观察组在改善肛门功能Wexner评分、LARS评分方 面明显优于对照组，差异均有统计学意义 （P＜0.05） 。 （4） 治疗后，2组患者血清TNF-α、IL-8、CRP水平均明显改善 （P＜ 0.05） ，且观察组在改善血清TNF-α、IL-8、CRP水平方面明显优于对照组，差异均有统计学意义 （P＜0.05） 。 （5） 观察组并发 症总发生率明显少于对照组，差异有统计学意义 （P＜0.05） 。 【结论】温针灸治疗结直肠癌肠造口还纳术后患者，可有效缩短 患者术后恢复时间，调节肠道菌群，改善肛门功能，降低造口周围感染等并发症的发生率，临床疗效显著。

Objective To observe the effect of warming-needle moxibustion on intestinal flora and anal function in patients after enterostomy. Methods A total of 94 patients with colorectal cancer enterostomy were randomly divided into observation group and control group，47 cases in each group. The control group was given routine treatment after operation，and the observation group was given warming-needle moxibustion treatment on the basis of the control group. Both groups were treated for two weeks. After two weeks of treatment，the changes of the relative abundance of Enterococcus，Escherichia coli，Lactobacillus，Bifidobacterium before and after treatment in the two groups，as well as the first exhaust time，the first feeding time and the hospitalization time were observed. The changes of constipation score scale （Wexner），low anterior resection syndrome （LARS） score， tumor necrosis factor α （TNF-α） ，interleukin 8 （IL-8） and C-reactive protein （CRP） were compared before and after treatment between the two groups，and the incidence of complications in the two groups was evaluated. Results （1） The first exhaust time，first feeding time and hospitalization time in the observation group were significantly less than those in the control group，and the differences were statistically significant（P＜0.05） . （2）After treatment，the relative abundance of Enterococcus，Escherichia coli，Lactobacillus，Bifidobacterium in the two groups was significantly improved （P＜0.05） ，and the observation group was significantly superior to the control group in improving the relative abundance of Enterococcus， Escherichia coli， Lactobacillus， Bifidobacterium（P＜0.05） . （3） After treatment，the Wexner score and LARS score of anal function in the two groups were significantly improved （P＜0.05），and the improvement of Wexner score and LARS score of anal function in the observation group was significantly superior to that in the control group，the differences were statistically significant （P＜0.05） . （4） After treatment，the levels of serum TNF-α，IL-8 and CRP in the two groups were significantly improved （P＜0.05） ，and the improvement of serum TNF-α，IL-8 and CRP levels in the observation group was significantly superior to that in the control group，the differences were statistically significant （P＜0.05） . （5） The total incidence of complications in the observation group was significantly lower than that in the control group， and the difference was statistically significant （P＜0.05） . Conclusion The treatment of warming-needle moxibustion for patients after enterostomy can effectively shorten the postoperative recovery time，regulate intestinal flora，improve anal function，and reduce the incidence of complications such as peristomal infection，with significant clinical effect.

R246.9

国家自然科学基金资助项目 （编号：81807544）；河北省中医药管理局科研基金资助项目 （编号：2023162）