Effects of bottle gourd moxibustion combined with umbilical therapy for cancer-related incomplete bowel obstruction on inflammatory cytokine levels

Table 1 Traditional Chinese medicine syndrome scoring evaluation criteria

Symptoms	None (0 points)	Mild (1 point)	Moderate (2 points)	Severe (3 points)
Flatulence	Normal flatulence	Presence of flatulence	Slight flatulence	Occasional flatulence
Defecation	Normal or slightly hard stools, smooth defecation	Hard stools, slightly difficult defecation	No bowel movement for more than 1 day, difficult and dry defecation	No bowel movement for 2 days or more
Abdominal pain	Almost none	Mild, occasional, can be relieved spontaneously	Pain localized, tolerable	Severe pain, unbearable, recurrent
Abdominal distension	Almost none	Occasionally bloated or postprandial bloating	Significant bloating, lasting longer, tolerable	Obvious bloating or drum-like distension, lasting long
Nausea	Almost none	Occasional nausea, short duration	Moderate nausea, lasting longer, still tolerable	Recurrent severe nausea, long duration, intolerable
Vomiting	None	Desire to vomit	Intermittent vomiting of saliva or food residue	Frequent vomiting or immediate vomiting after eating, intolerable

Table 2 Comparison of demographic characteristics between two groups, mean ± SD/n (%)

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	t/χ2	P value
Age (years)	66.49 ± 9.57	67.65 ± 10.14	0.612	0.542
Male/female	31 (54.39)/26 (45.61)	27 (51.92)/25 (48.08)	0.066	0.797
BMI (kg/m2)	23.78 ± 2.97	23.56 ± 3.14	0.378	0.706
Ethnicity			0.247	0.619
Han	44 (77.19)	38 (73.08)
Others	13 (22.81)	14 (26.92)
Smoking history			0	0.983
Yes	33 (57.89)	30 (57.69)
No	24 (42.11)	22 (42.31)
Drinking history			0.952	0.329
Yes	20 (35.09)	23 (44.23)
No	37 (64.91)	29 (55.77)
Diabetes history			0.265	0.607
Yes	15 (26.32)	16 (30.77)
No	42 (73.68)	36 (69.23)
Hypertension history			0.056	0.813
Yes	12 (21.05)	10 (19.23)
No	45 (78.95)	42 (80.77)
KPS			0.096	0.756
30-60	39 (68.42)	37 (71.15)
0-30	18 (31.58)	15 (28.85)

BGM-UT: Bottle gourd moxibustion combined with umbilical therapy; BMI: Body mass index; KPS: Kanofsky performance status.

Table 3 Comparison of disease characteristics between two groups, n (%)

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	χ2	P value
Causes of obstruction			1.443	0.486
Colorectal cancer	36 (63.16)	27 (51.92)
Metastatic tumor	14 (24.56)	16 (30.77)
Others	7 (12.28)	9 (17.31)
Sites of obstruction			0.214	0.898
Colon	26 (45.61)	26 (50.00)
Rectum	20 (35.09)	17 (32.69)
Others	11 (19.30)	9 (17.31)
Numbers of previous obstruction episodes			3.187	0.364
0	31 (54.39)	36 (69.23)
1	16 (28.07)	9 (17.31)
2	7 (12.28)	6 (11.54)
≥ 3	3 (5.26)	1 (1.92)

BGM-UT: Bottle gourd moxibustion combined with umbilical therapy.

Table 4 Comparison of the gastrointestinal function recovery between two groups during treatment, mean ± SD

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	t	P value
The first anal exhaust time (hours)	81.85 ± 20.87	74.35 ± 13.43	2.251	0.027
The first defecation time (hours)	104.7 ± 34.28	92.71 ± 27.27	2.009	0.047
The recovery time of bowel sound (hours)	91.51 ± 13.92	85.38 ± 12.54	2.408	0.018
The first solid food intake time (hours)	141.95 ± 56.89	123.25 ± 34.87	2.088	0.039

BGM-UT: Bottle gourd moxibustion combined with umbilical therapy.

Table 5 Comparison of brief pain inventory between two groups (baseline), mean ± SD

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	t	P value
BPI total	4.86 ± 1.27	4.89 ± 1.13	0.110	0.913
BPI intensity	5.04 ± 1.15	4.84 ± 1.26	0.889	0.376
BPI interference	5.17 ± 1.62	5.04 ± 1.38	0.471	0.638

BPI: Brief pain inventory; BGM-UT: Bottle gourd moxibustion combined with umbilical therapy.

Table 6 Comparison of brief pain inventory between two groups (1 week after treatment), mean ± SD

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	t	P value
BPI total	5.19 ± 1.45	4.62 ± 1.17	2.267	0.025
BPI intensity	5.02 ± 1.43	4.45 ± 1.24	2.232	0.028
BPI interference	5.39 ± 1.72	4.78 ± 1.03	2.276	0.025

BPI: Brief pain inventory; BGM-UT: Bottle gourd moxibustion combined with umbilical therapy.

Table 7 Comparison of individual symptom scores in traditional Chinese medicine between two groups three weeks after treatment, mean ± SD

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	t	P value
Number of diarrheas	2.31 ± 0.56	2.06 ± 0.21	3.146	0.002
Stool character	2.34 ± 0.55	2.16 ± 0.31	2.058	0.042
Abdominal pain	2.21 ± 0.65	1.96 ± 0.22	2.703	0.009
Abdominal distension	2.45 ± 0.31	2.28 ± 0.28	2.990	0.003

BGM-UT: Bottle gourd moxibustion combined with umbilical therapy.

Table 8 Comparison of inflammatory cytokine levels between two groups (baseline), mean ± SD

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	t	P value
IL-6 (pg/mL)	38.76 ± 8.41	39.24 ± 7.31	0.321	0.749
TNF-α (pg/mL)	59.62 ± 13.75	57.41 ± 15.43	0.792	0.430
CRP (mg/L)	31.65 ± 8.89	32.74 ± 9.12	0.632	0.529

IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; CRP: C-reactive protein; BGM-UT: Bottle gourd moxibustion combined with umbilical therapy.

Table 9 Comparison of inflammatory cytokine levels between two groups (1 week after treatment), mean ± SD

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	t	P value
IL-6 (pg/mL)	35.56 ± 7.23	32.83 ± 7.12	1.986	0.050
TNF-α (pg/mL)	52.78 ± 12.36	48.35 ± 10.57	2.005	0.047
CRP (mg/L)	28.47 ± 6.58	25.86 ± 6.89	2.024	0.045

IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; CRP: C-reactive protein; BGM-UT: Bottle gourd moxibustion combined with umbilical therapy.

Table 10 Comparison of inflammatory cytokine levels between two groups (3 weeks after treatment), mean ± SD

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	t	P value
IL-6 (pg/mL)	33.02 ± 7.15	29.45 ± 6.98	2.632	0.010
TNF-α (pg/mL)	50.12 ± 11.23	45.23 ± 9.78	2.412	0.018
CRP (mg/L)	26.14 ± 6.45	22.56 ± 6.21	2.944	0.004

IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; CRP: C-reactive protein; BGM-UT: Bottle gourd moxibustion combined with umbilical therapy.

Table 11 Comparison of quality of life scores between two groups (baseline), mean ± SD

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	t	P value
Physical functioning	52.13 ± 12.36	51.85 ± 11.92	0.119	0.906
Role functioning	49.54 ± 13.27	48.92 ± 12.85	0.248	0.805
Emotional functioning	50.12 ± 11.53	49.82 ± 11.22	0.141	0.888
Cognitive functioning	51.38 ± 10.72	50.93 ± 10.44	0.222	0.825
Social functioning	48.76 ± 12.16	48.44 ± 11.82	0.136	0.892

BGM-UT: Bottle gourd moxibustion combined with umbilical therapy.

Table 12 Comparison of quality of life scores between two groups (3 weeks after treatment), mean ± SD

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	t	P value
Physical functioning	64.09 ± 12.25	70.51 ± 12.59	2.698	0.008
Role functioning	64.66 ± 12.39	71.32 ± 12.77	2.760	0.007
Emotional functioning	57.64 ± 11.32	63.25 ± 11.58	2.559	0.012
Cognitive functioning	59.63 ± 10.73	66.15 ± 11.42	3.076	0.003
Social functioning	58.49 ± 11.48	65.08 ± 11.94	2.936	0.004

BGM-UT: Bottle gourd moxibustion combined with umbilical therapy.

Table 13 Comparison of adverse events between two groups, n (%)

Parameters	Regular group (n = 57)	BGM-UT group (n = 52)	χ2	P value
Skin erythema	0 (0.00)	2 (3.85)	0.608	0.435
Allergic reaction	0 (0.00)	1 (1.92)	0.142	0.877
Skin burns	0 (0.00)	0 (0.00)	0.000	1.000

BGM-UT: Bottle gourd moxibustion combined with umbilical therapy.

Table 14 Correlation between inflammatory cytokine reduction and gastrointestinal function recovery times

Gastrointestinal indicator	IL-6 reduction		TNF-α reduction		CRP reduction
	r	P value	r	P value	r	P value
First anal exhaust time	-0.31	0.006	-0.41	< 0.001	-0.49	< 0.001
First defecation time	-0.42	< 0.001	-0.35	0.002	-0.52	< 0.001
Bowel sound recovery	-0.29	0.011	-0.47	< 0.001	-0.45	< 0.001
First solid food intake	-0.38	0.001	-0.37	0.001	-0.51	< 0.001

IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; CRP: C-reactive protein.