加味香砂六君子汤对结肠癌患者术后肠内营养的影响

Effect of Modified Xiangsha Liujunzi Tang on Postoperative Enteral Nutrition of Patients with Colon Cancer

目的:观察加味香砂六君子汤对结肠癌患者术后肠内营养的影响。方法:将189例接受结肠癌根治术的结肠癌患者随机分为观察组100例及对照组89例。对照组术后24 h开始进行能全力肠内营养支持;观察组在对照组治疗方案的基础上加用加味香砂六君子汤治疗。于术前及术后7天、14天进行血常规、T淋巴细胞亚群、营养指标[白蛋白(Alb)、前白蛋白(PAlb)、血红蛋白(Hb)]、C-反应蛋白(CRP)、免疫球蛋白(Ig A、Ig G、Ig M)检测,并记录首次排气、排便时间及不良反应情况。结果:观察组术后7天、术后14天WBC均低于对照组,差异均有统计学意义(P<0.05)。术后7天、14天观察组RBC、PAlb、Ig A均高于对照组;术后7天,术后14天,观察组BPC高于对照组;术后14天,观察组Alb高于对照组,差异均有统计学意义(P<0.05)。2组Hb水平均无明显变化,前后比较,组间比较,差异均无统计学意义(P>0.05)。术后14天观察组CD3+、CD4+、CD4+/CD8+均高于对照组;术后7天观察组CD4+、CD4+/CD8+均高于对照组,差异均有统计学意义(P<0.05)。观察组术后7天Ig M,术后14天Ig G、Ig M均高于同期对照组,差异均有统计学意义(P<0.05)。观察组术后7天CRP升高,术后14天降至术前水平,且均低于对照组,组内前后比较,组间比较,差异均有统计学意义(P<0.05)。观察组术后首次排气时间、首次排便时间、胃肠道不良反应率均少于低于对照组,差异均有统计学意义(P<0.05)。结论:运用加味香砂六君子汤治疗,对结肠癌患者术后肠内营养有良好的影响,可以改善患者免疫低下和营养匮乏状况,减少患者恢复时间和不良反应出现率,提高生活质量。

Objective：To observe the effect of modified Xiangsha Liujunzi tang on postoperative enteral nutrition of patients with colon cancer.Methods：Divided 189 cases of patients with colon cancer after the treatment of colon carcinoma operation into the observation group being 100 cases and the control group being 89 cases randomly.The control group received enteral nutrition support of TPF 24 hours after operation,while the observation group was additionally treated with modified Xiangsha Liujunzi tang.Before operation and on the 7 th and 14 th day of treatment after operation,detected blood routine,T-lymphocyte subsets,nutritional indexes[albumin（Alb）,prealbumin（PAlb）,hemoglobin（Hb）],C-reactive protein（CRP）,and immunoglobulin（IgA,IgG,and IgM）,and recorded the time of first exhaust and time of defecating as well as adverse reaction.Results：On the 7 th and 14 th day after operation,WBC in the observation group were lower than those in the control group,differences being significant（P 0.05）.On the 7 th and 14 th day after operation,RBC,PAlb,and IgA in the observation group were all higher than those in the control group.On the 7 th and 14 th day after operation,BPC in the observation group was higher than that in the control group,while on the 14 th day after operation Alb in the observation group was higher than that in the control group,differences being significant（P 0.05）.Hb levels in the two groups had no obvious changes,and there were no significant differences being found in the comparisons of two groups before and after operation and the inter-group comparison（P 0.05）.On the 14 th day after operation,CD3＋,CD4＋,and CD4＋/CD8＋ in the observation group were all higher than those in the control group,and on the 7 th day after operation CD3＋,CD4＋,and CD4＋/CD8＋ in the observation group were all higher than those in the control group,differences being significant（P 0.05）.IgM in theobservation group on the 7 th day after operation and IgG and IgM on the 14 th day after operation were all higher than those in the control group in the same period,differences being significant（P 0.05）.CRP in the observation group increased seven days after operation and dropped to the preoperative level on the 14 th day after operation,both of which were lower than those in the control group,differences being significant in the comparisons of two groups before and after operation and the inter-group comparison（P 0.05）.The time of first exhaust,time of first defecating,and rate of gastrointestinal adverse reaction in the observation group were all lower and less than those in the control group,differences being significant（P 0.05）.Conclusion：The therapy of modified Xiangsha Liujunzi tang has a positive effect on postoperative enteral nutrition of patients with colon cancer,can improve conditions of patients with immune deficiency and nutritional deficiencies,and reduce recovery time of patients and the incidence of adverse reaction,thus to improve quality of life.