丁沉扶正汤对消化系统恶性肿瘤术后气滞血瘀型胃肠功能紊乱的疗效和Th1/Th2免疫漂移的影响

Effect of Dingchen Fuzheng Decoction on gastrointestinal function recovery and Th1/Th2 immune drift after operation of digestive system malignant tumor

目的探讨丁沉扶正汤对消化系统恶性肿瘤术后胃肠功能恢复和Th1/Th2免疫漂移的影响。方法选择2018年1月至2019年12月在河北省退役军人总医院行手术治疗的消化系统恶性肿瘤患者120例,根据随机数字表法将其分为观察组和对照组,各60例。观察组术后给予基础治疗及丁沉扶正汤治疗,对照组给予基础治疗及吗丁啉治疗。治疗1个月后观察两组术后各指标、胃动素、血管活性肠肽、细胞因子水平以及1型辅助性T细胞/2型辅助性T细胞(Th1/Th2)水平等。结果观察组肠鸣音恢复时间、术后首次排气时间、术后首次排便时间、术后恢复全流时间均低于对照组(P<0.01)。术后1个月两组胃动素水平均较术后第1天升高,血管活性肽水平均较术后第1天下降,且观察组胃动素水平高于对照组,血管活性肽水平低于对照组(P<0.05)。术后1个月两组白细胞介素(IL)-2水平均较术后第1天升高,IL-4、IL-6和γ干扰素(IFN-γ)水平均较术后第1天下降,且观察组IL-2水平高于对照组,IL-4、IL-6和IFN-γ水平低于对照组(P<0.05)。术后1个月观察组Th1/Th2水平高于对照组(P<0.05)。观察组术后并发症总发生率低于对照组(P<0.01)。结论丁沉扶正汤治疗消化系统恶性肿瘤术后胃肠功能紊乱的效果较好,并且可改善Th1/Th2漂移。

Objective To investigate the effect of Dingchen Fuzheng Decoction on gastrointestinal function recovery and Th1/Th2 immune drift after operation of digestive system malignant tumor.Methods A total of 120 patients with digestive system malignant tumor who underwent surgical treatment in Hebei General Hospital for Veterans from January 2018 to December 2019 were selected and they were divided into observation group and control group according to random number table method,with 60 cases in each group.The observation group was treated with basic treatment and Dingchen Fuzheng Decoction,while the control group was treated with basic treatment and Motilium.After one month of treatment,the postoperative indexes,motilin,vasoactive intestinal peptide,cytokine levels and type 1 helper T cells/type 2 helper T cells(Th1/Th2)levels of the two groups were observed.Results The recovery time of bowel sound,postoperative first exhaust time,postoperative first defecation time and postoperative total flow recovery time in the observation group were lower than those in the control group(P<0.01).One month after surgery,motilin levels in both groups were increased and vasoactive peptide levels were decreased compared with one day after surgery,and the motilin level in observation group was higher than that in control group,while vasoactive peptide level was lower than that in control group(P<0.05).One month after surgery,the levels of interleukin(IL)-2 in the two groups were increased and the levels of IL-4,IL-6,and interferon-γ(IFN-γ)were decreased compared with that one day after surgery,and the level of IL-2 in the observation group was higher than the control group.The levels of IL-4,IL-6,and IFN-γwere lower than those of control group(P<0.05).The Th1/Th2 level in the observation group was significantly higher than that in the control group one month after surgery(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.01).Conclusion Dingchen Fuzheng Decoction has a good effect on gastrointestinal dysfunction after operation of digestive system malignant tumor,and can improve Th1/Th2 drift.