益气活血通络汤联合还原型谷胱甘肽对腹腔镜结直肠癌根治术后患者肝功能及炎性-应激状态的影响

Effects of Yiqi Huoxue Tongluo decoction combined with reduced glutathione on liver function and inflammatory-stress state after laparoscopic radical resection of colorectal cancer

目的观察益气活血通络汤联合还原型谷胱甘肽对腹腔镜结直肠癌根治术后患者肝功能及炎性-应激状态的影响。方法将86例拟行腹腔镜根治术的结直肠癌患者随机分为对照组和观察组,每组43例。对照组术前给予还原型谷胱甘肽治疗,观察组在对照组治疗基础上给予益气活血通络汤治疗,用至术后7 d。观察2组术前及术后1,3,7 d肝功能指标、炎性-应激状态相关指标水平及肝损伤发生率,记录2组并发症、临床结局情况。结果 2组术后1 d ALT、AST、GGT、TBil阳性率和平均水平均显著增高,随后逐渐降低,观察组上述指标阳性率和平均水平均显著低于对照组,差异有统计学意义(P均<0.05);2组术后1 d血清IL-6、IL-8、TNF-α、MDA水平显著升高,随后逐渐降低,血清SOD、GSH-Px水平则呈现相反趋势,且观察组血清IL-6、IL-8、TNF-α、MDA水平均显著低于对照组(P均<0.05),血清SOD、GSH-Px水平均高于对照组,差异有统计学意义(P均<0.05);观察组术后并发症发生率显著低于对照组,临床结局(术后下床时间、排尿时间、排气时间、排便时间、进半流食时间、术后住院时间、住院总时间、住院总费用)均优于对照组,差异有统计学意义(P均<0.05)。结论益气活血通络汤联合还原型谷胱甘肽能够减轻腹腔镜结直肠癌根治术后的肝功能损伤,减少并发症,促进患者康复,缩短住院时间,可能与二者联合应用可明显抑制手术造成的炎性-应激状态有关。

Objective It is to observe the effect of Yiqi Huoxue Tongluo decoction combined with reduced glutathione on liver function and inflammatory-stress state after laparoscopic radical resection of colorectal cancer.Methods Eighty-six patients with colorectal cancer who were scheduled to undergo laparoscopic radical resection were randomly divided into control group and observation group,43 cases in each group.The control group was treated with reduced glutathione before operation.On the basis of the control group,the observation group was given Yiqi Huoxue Tongluo decoction after admission until 7 days after the operation.The liver function indexes,inflammatory-stress state related indicators and the incidence of liver injury were observed in the two groups before and 1,3 and 7 days after operation.The complications and clinical outcome of the two groups were recorded.Results The positive rates and average levels of ALT,AST,GGT and TBil in the two groups were significantly higher 1 day after operation,then gradually reduced,the positive rate and average level of the above indicators in the observation group were significantly lower than those in the control group（all P〈0.05）.The serum levels of IL-6,IL-8,TNF-α,MDA in the two groups were increased significantly 1 day after operation,and then gradually decreased;the level of serum SOD and GSH-Px showed the opposite trend.The serum levels of IL-6,IL-8,TNF-α and MDA in the observation group were significantly lower than those in the control group（all P〈0.05）;the levels of serum SOD and GSH-Px in the control group were significantly higher than those in the control group（all P〈0.05）.The incidence of postoperative complications in the observation group was significantly lower than that in the control group（P〈0.05）.The clinical outcome（postoperative bed time,urination time,exhaust time,defecation time,feeding time,hospitalization time after operation,total hospitalization time,total hospitalization cost） were all better significantly than those of the control group（P〈0.05）.Conclusion Yiqi Huoxue Tongluo decoction combined with reduced glutathione can reduce the liver function injury after laparoscopic radical resection of colorectal cancer,decrease complications,promote the recovery of patients and shorten the time of hospitalization.It may be associated with the combination of the two drugs can significantly inhibit the inflammatory stress state caused by surgery.