腹腔镜手术后肠内滴注归脾汤治疗胃癌患者术后疲劳综合征研究

Effects of Guipi Tang (归脾汤) on Treatment for Postoperative Fatigue Syndrome in Post-Laparoscopic Gastric Cancer Resection Patients

目的:观察腹腔镜手术后肠内营养管滴注归脾汤治疗胃癌根治术后疲劳综合征的效果。方法:将58例胃癌手术患者随机分为开腹组19例、腹腔镜组19例、腹腔镜归脾汤组20例,术后第2～8d均给予肠内营养支持,腹腔镜归脾汤组同时予肠内营养管滴注归脾汤100mL/d,共用7d;用视觉模拟疲劳尺、心境量表分别评估手术前后疲劳程度、心境变化;术后2、8d检测蛋白水平、T淋巴细胞亚群(CD4、CD8)。结果:腹腔镜归脾汤组恢复更快,心境状态和术后疲劳程度优于开腹组和腹腔镜组(P<0.05);术后8d血清前白蛋白、白蛋白、CD4、CD4/CD8均比开腹组和腹腔镜组相应指标增高(P<0.05)。结论:胃癌采用腹腔镜手术,术后早期行肠内营养联合归脾汤滴注是安全且有效的,能改善机体的营养状态和术后疲劳综合征。

Objective To evaluate the effect of the Guipi Tang on treatment for postoperative fatigue syndrome （POFS） in the post-laparoscopic gastric cancer resection patients.Methods Fifty eight patients cases who underwent gastric cancer resection were randomly divided into 3 groups：open resection group A,19 cases,laparoscopic resection group B,19 cases,laparoscopic resection with Guipi Tang infusion （归脾汤） group C,20 cases,all patients were given the enteral nutrition from post-operative day 2 to 8,while patients in group A were given with additional Guipi Tang.The visual analog scales（VAS）,profile of mood states （POMS）,the serum protein concentration and the T lymphocyte subsets count （CD4 、 CD8） were observed.Results Patients in group C were recovered more quickly than those in other groups,and the VAS 、 POMS were better than those in groups A and B （P0.05）,in the postoperative day 8;the pre-protein,protein,CD4,CD8 were better in group C than those in group A or B（P0.05）.Conclusion Using the laparoscope for treating gastric cancer is effective and safe,additional nutrition supplement and Guipi Tang by the enteral way in the early postoperative stage can improve the nutritious status and POFS.