香砂六君子协定方联合谷氨酰胺、二十碳五烯酸、支链氨基酸补充对食管癌术后患者免疫功能及营养指标的影响

Effects of Xiangsha Liujunzi Xieding Decoction combined with western medicine on postoperative nutritional index in patients with esophageal cancer

目的观察香砂六君子协定方联合谷氨酰胺、二十碳五烯酸(EPA)、支链氨基酸补充对食管癌术后患者免疫功能及营养指标的影响。方法将100例食管癌术后患者按照随机数字表法分为2组,对照组50例术后采用常规营养支持+谷氨酰胺、EPA、支链氨基酸补充。治疗组50例在对照组治疗基础上予香砂六君子协定方治疗。持续治疗3周(21 d)。观察比较2组干预前后T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、免疫球蛋白A(IgA)、IgG、IgM、生理应激反应[收缩压(SBP)、舒张压(DBP)和心率(HR)]、预后营养指数(PNI)及营养指标。结果2组治疗后CD4^(+)、CD4^(+)/CD8^(+)水平均较本组治疗前降低(P<0.05),CD8^(+)水平均升高(P<0.05),且治疗组治疗后CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组(P<0.05),CD8^(+)水平低于对照组(P<0.05)。2组治疗后IgA、IgG、IgM水平均较本组治疗前降低(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组治疗后SBP、DBP、HR均较本组治疗升高(P<0.05),治疗组治疗后均低于对照组(P<0.05)。治疗组治疗后PNI、血红蛋白及总蛋白均较本组治疗前升高(P<0.05),对照组血红蛋白及总蛋白均升高(P<0.05),PNI降低(P<0.05),且治疗组治疗后PNI、血红蛋白及总蛋白均高于对照组(P<0.05)。结论香砂六君子协定方联合谷氨酰胺、EPA、支链氨基酸补充可以有效改善食管癌术后患者的免疫功能,降低生理应激反应,维持并提高患者营养状态,改善患者预后,值得临床推广。

Objective To analyze the effects of Xiangsha Liujunzi Decoction combined with glutamine,eicosapentaenoic acid(EPA),and branched-chain amino acid(BCAA)supplementation on postoperative immune function and nutritional indicators in patients with esophageal cancer(EC).Methods A total of 100 EC patients were randomly allocated in 1∶1 ratio to two groups.On the basis of routine nutrition support+glutamine,EPA,BCAA supplementation(the control group),the treatment group was additionally treated with Xiangsha Liujunzi Xieding Decoction.The treatment were performed for three weeks(21 d),T lymphocyte subsets(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),immunoglobulin A(IgA),IgG,IgM,physiological stress response(systolic blood pressure[SBP],diastolic blood pressure[DBP]and heart rate[HR]),prognostic nutritional index(PNI)and nutritional indicators were included as comparisons.Results After intervention,CD4^(+),CD4^(+)/CD8^(+),IgA,IgG and IgM decreased,while CD8^(+),SBP,DBP and HR increased(all P<0.05),There were statistically significant differences in above indexes between groups.Compared with before intervention,PNI,hemoglobin,and total protein were significantly increased in the observation group(P<0.05),while hemoglobin and total protein were increased(P<0.05)and PNI index was decreased in the control group(both P<0.05),there were statistically significant difference32s in PNI,hemoglobin,and total protein between groups(P<0.05).Conclusion For EC patients,Xiangsha Liujunzi Xieding Decoction combined with glutamine,EPA,BCAA supplementation can effectively improve postoperative immune function,reduce physiological stress response,maintain and improve the nutritional status and improve the prognosis,which is worthy of clinical promotion.