胃癌术后四君子汤联合营养支持对应激炎症反应、免疫应答反应的影响

Effect of Sijunzi decoction combined with nutritional support after gastric cancer surgery on the stress inflammatory response and immune response

目的:研究胃癌术后四君子汤联合营养支持对应激炎症反应、免疫应答反应的影响。方法:选择本院进行的胃癌根治术病例,随机分为术后接受四君子汤联合肠内营养支持的观察组、接受常规肠内营养支持的对照组。手术前及手术后3天,测定血清中应激炎症反应指标及外周血中免疫应答指标。结果:手术后3天,两组血清中Cor、Gluc、Ins、O_2^-、CRP、TNF-α、YKL-40、MK、IL-6的含量以及外周血中GATA-3、RORγt、Foxp3表达量表达量高于手术前,血清中HO-1、SOD的含量以及外周血中CD3^+CD4^+T细胞、CD3^+CD8^+T细胞、CD16^+CD56^+NK细胞、CD19^+B细胞含量、T-bet表达量均低于手术前且观察组患者血清中Cor、Gluc、Ins、O_2^-、CRP、TNF-α、YKL-40、MK、IL-6的含量以及外周血中GATA-3、RORγt、Foxp3表达量表达量均低于对照组,血清中HO-1、SOD的含量以及外周血中CD3^+CD4^+T细胞、CD3^+CD8^+T细胞、CD16^+CD56^+NK细胞、CD19^+B细胞含量、T-bet表达量均高于对照组。结论:胃癌术后四君子汤联合营养支持能够减轻应激炎症反应、增强免疫应答。

Objective：To study the effect of Sijunzi decoction combined with nutritional support after gastric cancer operation on the stress inflammatory response and immune response.Methods：Patients who received radical operation for gastric cancer in West China Hospital between March 2015 and August 2017 were selected and randomly divided into the observation group who accepted Sijunzi decoction combined with enteral nutrition support after operation and the control group who accepted routine enteral nutrition support after operation.The stress inflammatory response indexes in serum and the immune response indexes in peripheral blood were measured before operation and 3 days after operation.Results：3 days after operation,Cor,Gluc,Ins,O2^-,CRP,TNF-α,YKL-40,MK and IL-6 contents in serum as well as GATA-3,RORγt and Foxp3 expression in peripheral blood of both groups were higher than those before operation（P〈0.05）whereas HO-1 and SOD contents in serum as well as CD3^＋CD4^＋T cell,CD3^＋CD8^＋T cell,CD16^＋CD56^＋NK cell and CD19^＋B cell contents and T-bet expression in peripheral blood were lower than those before operation（P〈0.05）,and Cor,Gluc,Ins,O2^-,CRP,TNF-α,YKL-40,MK and IL-6 contents in serum as well as GATA-3,RORγt and Foxp3 expression in peripheral blood of observation group were lower than those of control group（P〈0.05）whereas HO-1 and SOD contents in serum as well as CD3^＋CD4^＋T cell,CD3^＋CD8^＋T cell,CD16^＋CD56^＋NK cell and CD19^＋B cell contents and T-bet expression in peripheral blood were higher than those of control group（P〈0.05）.Conclusion：Sijunzi decoction combined with nutritional support after gastric cancer operation can reduce the stress inflammatory response and enhance the immune response.