快速康复外科联合香砂六君子汤对进展期胃癌患者术后早期胃肠道功能恢复的影响

Effect of Fast-Track Surgery Combined with Xiangsha Liujunzi Decoction on Early Postoperative Recovery of Gastrointestinal Function in Patients with Advanced Gastric Cancer

目的探讨快速康复外科联合香砂六君子汤对进展期胃癌患者术后早期胃肠道功能恢复的影响。方法将90例行胃癌根治术的进展期胃癌患者按随机抽签法分为空白组、对照组和试验组,每组30例。空白组在围术期给予常规处理。对照组在围术期给予快速康复外科。试验组在围术期于术前3d采用香砂六君子汤治疗,同时给予快速康复外科。观察3组术后下床时间、肠鸣音恢复时间、肛门排气时间、进流质时间及术后第1天血清胃动素(MTL)、胃泌素(GAS)、生长抑素(SS)水平的变化。结果试验组术后下床时间、肠鸣音恢复时间、肛门排气时间、进流质时间均较空白组、对照组短(均P<0.05)。术后第1天,试验组血清MTL、GAS水平均较空白组、对照组升高,而血清SS水平较空白组、对照组降低(均P<0.05);对照组血清MTL、GAS水平均较空白组升高,而血清SS水平较空白组降低(均P<0.05)。结论快速康复外科联合香砂六君子汤应用于进展期胃癌能够有效促进患者胃肠道功能的恢复,促进患者术后康复。

Objective To investigate the effect of fast-track surgery combined with Xiangsha Liujunzi decoction on early postoperative recovery of gastrointestinal function in patients with advanced gastric cancer. Methods Ninety patients with advanced gastric cancer undergoing radical gastrectomy were randomly given conventional treatment（blank group, n =30）,fast-track surgery（control group, n =30）,or Xiangsha Liujunzi decoction（3 days before operation） combined with fast-track surgery（experimental group, n =30） during perioperative period.The time to off-bed activity,presence of bowel sounds,first passage of flatus and liquid diet intake was recorded in all groups.In addition,serum levels of motilin（MTL）,gastrin（GAS） and somatostatin（SS） were measured on postoperative day 1. Results The time to off-bed activity,presence of bowel sounds,first passage of flatus and liquid diet intake in experimental group was shorter than that in blank group or control group（ P 〈0.05）.On postoperative day 1,compared with blank group or control group,serum MTL and GAS levels increased but SS level decreased in experimental group（ P 〈 0.05 ）.Compared with blank group,serum MTL and GAS levels rose but SS level reduced in control group（ P 〈0.05）. Conclusion Fast-track surgery combined with Xiangsha Liujunzi decoction can effectively promote gastrointestinal function recovery and postoperative rehabilitation in patients with advanced gastric cancer.