肠内营养及中药对胃癌术后化疗患者营养状态和脾虚证候的影响

目的 探讨肠内营养及中药对胃癌术后化疗患者营养状态和脾虚证候的影响.方法 胃癌术后化疗患者84例,随机分为3组,分别为肠内营养支持加中药的干预组31例、肠内营养支持的营养组21例、单纯化疗的空白组32例.比较4周期化疗前后三组营养状况(体重、体质指数BMI、NRS2002评分、PG-SGA评分、血清总蛋白、白蛋白、前白蛋白)及脾虚证候的评分.结果 干预组与空白组比较,4周期化疗前后,营养状态明显改善,体重、体质指数BMI、血清总白蛋等显著升高,NRS2002评分、PG-SGA评分显著降低,差异均有统计学意义(P<0.05),脾虚证候中4周期化疗前后纳呆、便溏、腹胀差异有统计学意义(P<0.05).结论 抗肿瘤化疗使胃癌术后患者出现不同程度的营养不良状态及脾虚证候,且随着化疗次数的增加而逐渐加重;肠内营养及中药治疗较单纯肠内营养支持能够更有效的改善患者的营养状态,减轻脾虚证候,提高患者的生存质量.

Objective To study the effects of enteral nutrition and traditional Chinese medicine on nutritional status and spleen deficiency syndrome of postoperative chemotherapy patients with gastric cancer. Methods Eighty-four patients with gastric cancer after operation were randomly divided into three groups: enteral nutrition group(n=31),blank group(n=32)and enteral nutrition group(n=21). The nutritional status(body weight,body mass index(BMI)NRS2002 score,PG-SGA score,serum total protein,albumin,prealbumin,spleen deficiency syndrome and score were observed. Results Compared with the control group,the nutritional status of the intervention group was significantly improved,the body weight,body mass index(BMI),serum total white egg andPG-SGA score were significantly increased before and after 4 cycles chemotherapy. The difference was statistically significant(P<0.05).but the difference was significant(P<0.05)before and after 4 cycles of chemotherapy in the syndrome of spleen deficiency,and the difference of abdominal distension was significant(P<0.05). Conclusion Anti-tumor chemotherapy causes different degrees of malnutrition and spleen deficiency syndrome in patients with gastric cancer after operation,and gradually aggravates with the increase of chemotherapy times. Enteral nutrition and traditional Chinese medicine therapy can effectively improve the nutritional status of the patients,reduce or improve the spleen deficiency syndrome,and improve the quality of life of the patients compared with the simple enteral nutrition support.