八珍汤辅助肠内营养对胃癌术后患者营养状况及免疫功能的影响

Effect of Bazhen Decoction Assisted with Enteral Nutrition on Nutritional Status and Immune Function in Patients with Gastric Cancer after Operation

目的:观察八珍汤辅助肠内营养(EN)对胃癌术后患者营养状况及免疫功能的影响。方法:将88例患者随机分为3组。对照组术后给予等热量、等氮肠外营养(PEN)支持9天。治疗A组术后第2天始给予等热量、等氮EN支持8天。治疗B组在治疗A组的基础上于术后第2～9天经鼻饲管给予中药八珍汤。术前1天,术后第1、10天分别检测IgA、IgG、CD4^+、CD8^+和CD4^+/CD8^+等免疫指标及血清白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(TRF)等营养指标。结果:术后第1天,各组营养及免疫各项指标分别与术前比较,差异均有显著性意义(P<0.05)。术后第10天,治疗A、B组免疫及营养各项指标分别与对照组比较,差异均有显著性意义(P<0.05),且治疗B组免疫及营养各项指标分别与治疗A组比较,差异均有显著性意义(P<0.05)。结论:胃癌术后采用八珍汤辅助EN能进一步改善机体营养状况和免疫功能。

Objective： To observe the effect of postoperative application of Bazhen Decoction assisted with enteral nutrition on nutritional status and immune function in patients with gastric cancer. Methods： Eighty-eight gastric cancer patients were randomly divided into three groups. The control group was given an isocaloric and isonitrogonous parenteral diet for 9 days. The treatment group A was given an isocaloric and isonitrogonous enteral diet, which was started on the second day after operation and continued for 8 days. And on the same basic treatment as that for treatment group A, treatment group B was given intranasal gavage of Bazhen Decoction from the second day to the ninth day after operation. Indexes of nutritional status such as serum prealbumin （PA）, albumin（AIb）, and transferrin （TRF）, and immune indexes such as IgA, IgG, CD4^＋, CD8^＋ and CD4^＋/CD8^＋ ratio were measured one day before operation and on the first and tenth day after operation. Results： The differences of all the nutritional and immune indexes were significant before operation and the first day after operation in three groups （P 〈 0.05）. On the tenth day after operation, the indexes of immune and nutritional status in the two treatment groups were improved as compared with those in the control group（P 〈 0.05）, and the improvement in the treatment group B was superior to that in the treatment group A（P 〈 0.05）. Conclusion： Bazhen Decoction assisted with enteral nutrition can positively improve cellular immune function and nutritional status of the patients with gastric cancer after operation.