健脾益气法联合早期肠内营养对胃癌术后患者营养状况及免疫功能的影响

The Effect of the Method of Jianpiyiqi Combined with the Early Enteral Nutrition on Nutritional Status and Immuneresponse of Postoperative Patients with Gastric Cancer

目的:观察鼻饲健脾益气中药联合早期肠内营养对胃癌患者术后营养状况和免疫功能的影响。方法:采用随机数字表法将符合筛选要求的60例胃癌手术患者随机分成治疗组和对照组,每组30例。两组患者均术后第2天开始通过鼻肠营养管给予瑞能肠内营养支持,治疗组患者在此基础上给予四君子汤加减治疗,连续治疗至术后第7天。所有患者均于术前、术后第8天测量体质量、术前和术后第1、第8天上臂围(AMC)、三头肌皮褶厚度(TSF)、血红蛋白(Hb)、白蛋白(Alb)、前白蛋白(PA)、免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)、免疫球蛋白A(Ig A)、CD3^+、CD4^+、CD4^+/CD8^+比值等。结果:两组患者除AMC、TSF手术前后差异无统计学意义(P>0.05)外,其余各项营养及免疫项指标术后第1天均较术前降低,差异均有统计学意义(P<0.05),但组间比较,各指标差异无统计学意义(P>0.05);术后第8天,治疗组患者各项免疫及营养指标改善均优于对照组,差异均有统计学意义(P<0.05)。结论:健脾益气中药联合早期肠内营养能改善胃癌患者术后营养状况和免疫功能,从而促进患者早日康复。

Objective To observe the effect of nasal feeding Jianpiyiqi decotion combined with early enteral nutrition on nutritional status and immune function in postoperative patients with gastric cancer. Methods 60 patients with gastric cancer were randomly divided into two groups： treatment group and control group, 30 cases in each group. Both groups were given enteral nutrition emulsion through the nasal tube two days after the operation,last for 6 days.In addition, the treatment group was given Sijunzi decotion. All patients were measured the weight before the operation and at the eighth day after the operation,and were measured Upper arm circumference（UAC）, triceps skinfold（TSF）, hemoglobin（HB）, albumin（ALB）, prealbumin（PA）, Immunoglobulin G（IgG）, Immunoglobulin M（IgM）, Immunoglobulin A（IgA）, CD3^＋, CD4^＋, CD4^＋ / CD8^＋ and so on before the operation, the day after the operation and at the eight days after the operation. Results AMC and TSF of both groups are no statistical significance before and after the operation（P〉0.05）, and the rest of the nutrition and immune indexes of 1 day after the operation were lower before the operation（P〈0.05）;There was no statistical significance between the two groups（P〉0.05）.At the eight days after the operation, the immune and nutritional indexes of the treatment group were better than those of the control group（P〈0.05）. Conclusion The method of Jianpiyiqi combined with the early enteral nutrition can improve the nutritional status and immune function in patients with gastric cancer after operation, so as to promote the recovery of patients earlier.