柴芍六君子汤加减联合ERAS对腹腔镜胃癌手术康复的影响

Effects of Modified Chaishao Liujunzi Decoction Combined with Enhanced Recovery after Surgery on Rehabilitation of Laparoscopic Gastric Cancer Surgery

目的观察柴芍六君子汤加减联合加速康复外科(ERAS)治疗在腹腔镜胃癌手术患者中的安全性和有效性。方法将腹腔镜胃癌D2根治术的患者84例随机分为对照组(ERAS组)44例和观察组(中药配合ERAS组)40例。两组均按ERAS管理,观察组术后加服柴芍六君子汤加减。观察比较两组患者术前及术后第1天、第3天、第5天血清白蛋白(albumin,ALB)、C反应蛋白(Creactive protein, CRP)、白细胞(white blood cell,WBC)水平及术后排气时间、排便时间、住院时间和手术并发症发生率。结果术后第1天两组WBC、CRP均较术前明显上升(P<0.05),ALB明显下降(P<O.05);术后第3天、第5天两组ALB水平较术后第1天升高(P<0.05),WBC、CRP水平较术后第1天下降(P<0.05),且观察组各项指标改善均优于对照组(P<0.05)。术后观察组排气、排便时间均较对照组提前(P<0.05),住院天数短于对照组(P<0.05)。两组术后并发症发生率差异无统计学意义(P>0.05)。结论腹腔镜胃癌手术患者在ERAS管理同时术后加服柴芍六君子汤加减安全有效,可进一步加速术后康复。

Objective To observe the safety and efficacy of Chaishao Liujunzi Decoction combined with enhanced recovery after surgery(ERAS)in patients undergoing laparoscopic gastric cancer surgery.Methods A total of 84 cases of gastrointestinal surgery underwent laparoscopic D2 radical gastrectomy were randomly divided into 44 cases of the control group(ERAS group)and40 cases of the observation group(Chinese materia medica and ERAS group).Both groups were managed according to ERAS.Modified Chaishao Liujunzi Decoction was added to the observation group after surgery.The serum albumin(ALB),C-reactive protein(CRP),and white blood cell(WBC)of the 2 groups before surgery and 1 st,3 rd,and 5 thday after surgery and postoperative evacuation time,defecation time,hospitalization time and incidence of surgical complications were observed and compared.Results On the 1 st day after surgery,WBC and CRP in both groups were significantly increased than before surgery(P<0.05),and ALB was significantly decreased(P<0.05);the ALB levels in the 2 groups on the 3 rdand 5 thday after surgery were increased than those on the 1 stday after surgery(P<0.05),and WBC and CRP levels decreased compared with the 1 st day after surgery(P<0.05),and the improvement of each index in the observation group was better than that in the control group(P<0.05).After surgery,the observation group’s evacuation and defecation time were earlier than the control group(P<0.05),and the hospital stay was shorter than the control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the 2 groups(P>0.05).Conclusion It is safe and effective to use Chaishao Liujunzi Decoction in laparoscopic gastric cancer patients after ERAS management,which can further accelerate the recovery after surgery.