黄芪四君子汤联合肠外营养支持促进胃癌患者术后恢复的研究

Clinical Observation on Huangqi Sijunzi Decoction Combined with Parenteral Nutrition in Promoting Postoperative Recovery of Gastric Cancer Patients

【目的】观察黄芪四君子汤联合肠外营养支持对胃癌患者术后恢复的影响。【方法】将80例胃癌患者随机分为治疗组和对照组各40例。两组均于术后第3天开始给予肠外营养支持,治疗组在上述治疗基础上给予黄芪四君子汤内服。观察两组患者的肛门恢复排气时间、切口感染率、生化指标和免疫指标。【结果】治疗组的肛门恢复排气时间为(2.40±0.33)d,对照组为(3.82±0.26)d,两组比较,差异有显著性意义(P<0.05);创口愈合情况:治疗组发生切口感染1例,对照组为4例。术后第3天,两组血清白蛋白和前白蛋白水平均较术前显著性下降(P<0.05);经治疗,于术后第10天,两组血清白蛋白和前白蛋白水平均有升高,并已基本达到术前水平(P>0.05);两组比较,治疗组的前白蛋白水平的升高较对照组显著(P<0.05)。术前两组的IgG、IgA、IgM均处于低水平状态,术后第3天两组的IgG、IgA、IgM水平较术前均有显著性下降(P<0.05);术后第10天,治疗组上述指标均有显著性升高,并已基本达到术前水平(P>0.05),而对照组升高不明显(与术前比较,P<0.05)。【结论】黄芪四君子汤配合肠外营养支持能促进胃癌患者术后的恢复,改善机体的免疫状况,减少切口的感染率。

[ Objective ] To observe the effect of Huangqi Sijunzi Decoction （HSD） combined with parenteral nutrition in promoting postoperative recovery of gastric cancer patients. [ Methods] Eighty gastric cancer patients were randomized into two groups. On the 3rd day after operation, the two groups received parenteral nutrition, and the treatment group （group A） was given HSD additionally. The anal exsufflation time, incision infection rate, biochemical indexes and immune indexes of the two groups were observed. [ Results ] The anal exsufflation time was （2.40 ± 0. 33） days in the treatment group and （3.82 ±0. 26） days in the control group, the difference being significant （P 〈 0.05 ）. Incision infection occurred in 1 patients of the treatment group and in 4 of the control group. On the 3rd day after operation, the albumin and pre-albumin levels were decreased in the two groups as compared with those before operation （P 〈0.05） ; on the 10th day after operation, the albumin and pre-albumin levels arrived to the levels before operation （ P 〉 0.05 ）. The increase of pre-albumin in the treatment group was obvious as compared with that in the control group （P 〈 0.05）. IgG, IgA and IgM levels were low before operation, and decreased obviously on the 3rd day after operation, but increased obviously on the 10th day after operation and arrived to the levels before operation （P 〉 0.05）. The increase of immune indexes was not obvious in the control group （P 〈 0.05 as compared with that before operation）. [ Conclusion] HSD combined with parenteral nutrition can promote postoperative recovery of gastric cancer patients, improve the immune status and decrease incision infection rate.