归脾汤小肠内滴注辅助治疗腹腔镜胃癌根治术后疲劳综合征临床观察

Therapeutic Effect of Guipi Decoction as Adjuvent Treatment for Postoperative Fatigue Syndrome in Pa tients undergone Laparoscopy-assisted Radical Gastrectomy for Gastric Cancer

目的:观察归脾汤小肠内滴注对腹腔镜胃癌根治术后疲劳综合征的改善作用。方法:39例胃癌患者术前随机分为对照组19例,观察组20例,两组术后均给予等氮、等热量肠内营养支持。观察组同时给予肠内滴注归脾汤100mL,1天1次,共7天。观察两组术后一般情况,分别应用视觉模拟疲劳尺、心境量表评估手术前后患者疲劳程度、心境变化。于术后第2、8天检测血清蛋白水平(总蛋白、白蛋白、前白蛋白)、T淋巴细胞亚群(CD4+、CD8+、CD4+/CD8+)。结果:腹腔镜胃癌手术后中药小肠内滴注未增加术后并发症,观察组心境状态好于对照组(P<0.05),术后疲劳程度较对照组减轻明显(P<0.05);术后8天观察组血清前白蛋白、白蛋白、CD4+、CD4+/CD8+等观察指标均比对照组增高(P<0.05)。结论:胃癌患者腹腔镜手术后早期行肠内营养联合中药滴注安全有效,能明显改善机体的营养状态和术后疲劳综合征。

Objective： To observe the therapeutic effect of Guipi decoction on the treatment of postoperative fa- tigue syndrome in patients received laparoscopy-assisted radical gastrectomy for gastric cancer. Methods： A total of 39 patients with gastric cancer were randomly divided into control group（n=19） and medicine group（n=20）. Both groups received the same enteral nutrition support after operation. The medicine group received extra Guipi decoction given at the dose of 100 ml through small bowel drip once a day for 7 days. General performance was observed in both groups. Visual analogue scales and profile of mood states were used to compare. Serum lev- els of total protein, albumin, and prealbumin, and T cell subpopulations（CD4＋, CD8＋, CD4＋/CD8＋） were deter- mined on day 2 and 8 after operation. Results： Extra Guipi decoction did not increase the incidence of compli- cations of radical gastrectomy for gastric cancer. Patients received Guipi decoction had better performance in visu- al analogue scales and profile of mood state test（both P〈O.05）. Except the serum level of total protein, other in- dex were all higher in the medicine group as compared to those in the control group（P〈0.05）. Conclusion： En- teral nutrition combined with Guipi drip at the early stage after operation can improve the nutritional status and attenuate the postoperative fatigue syndrome in patients received laparoscopy-assisted radical gastrectomy for gas- tric cancer.