扶正解毒方联合双歧杆菌三联活菌片治疗胃癌术后脾胃气虚证临床研究

Clinical Study on Combination Use of Fuzheng Jiedu Prescription and Bifidobacterium Triple Viable Tablets for Syndrome of Spleen-Stomach Qi Deficiency After Surgery of Gastric Cancer

目的:观察扶正解毒方联合双歧杆菌三联活菌片治疗胃癌术后脾胃气虚证的临床疗效,以及对肠道微生态及营养指标的影响。方法:选取90例胃癌术后脾胃气虚证患者,采用随机数字表法分为对照组和研究组各45例。术后进食开始后,对照组给予双歧杆菌三联活菌片治疗,研究组在对照组基础上给予扶正解毒方治疗,2组均治疗14 d。比较2组临床疗效、中医证候积分、肠道菌群(乳酸杆菌、粪肠球菌、双歧杆菌、大肠杆菌)、营养指标(白蛋白、总蛋白)及并发症发生率。结果:治疗14 d后,临床疗效优良率研究组75.56%,高于对照组60.00%(P<0.05)。治疗14 d后,2组腹痛、腹胀、恶心、食少纳呆、神疲乏力、便溏、面色无华积分均较术后5 d降低(P<0.05),研究组上述7项中医证候积分均低于对照组(P<0.05)。治疗14 d后,2组乳酸杆菌、双歧杆菌数量均较术后5d增多(P<0.05),粪肠球菌、大肠杆菌数量均较术后5 d减少(P<0.05);研究组乳酸杆菌、双歧杆菌数量均多于对照组(P<0.05),粪肠球菌、大肠杆菌数量均少于对照组(P<0.05)。治疗14 d后,2组白蛋白、总蛋白水平均较术后5 d升高(P<0.05),研究组白蛋白、总蛋白水平均高于对照组(P<0.05)。治疗期间,并发症发生率研究组8.89%,与对照组13.33%比较,差异无统计学意义(P>0.05)。结论:扶正解毒方联合双歧杆菌三联活菌片治疗可改善胃癌术后脾胃气虚证患者的肠道微生态及营养状况,有效缓解临床症状,效果优于仅使用双歧杆菌三联活菌片治疗。

Objective:To observe the clinical effect of the combination use of Fuzheng Jiedu Prescription and Bifidobacterium Triple Viable Tablets on syndrome of spleen-stomach qi deficiency after surgery of gastric cancer,and its effects on intestinal microecology and nutritive indexes.Methods:A total of 90 cases of patients with syndrome of spleen-stomach qi deficiency after surgery of gastric cancer were selected and divided into the control group and the study group according to the random number table method,with 45 cases in each group.After postoperative food taking started,the control group was treated with Bifidobacterium Triple Viable Tablets,and the study group was treated with Fuzheng Jiedu Prescription based on the treatment of the control group.Both groups were treated for 14 days.The clinical effects,traditional Chinese medicine(TCM)syndrome scores,intestinal flora(Lactobacillus,Enterococcus faecalis,Bifidobacterium and Escherichia coli),nutritive indexes(albumin and total protein)and incidence of complications were compared between the two groups.Results:After 14 days of treatment,the excellent rate of clinical effect in the study group was 75.56%,higher than that of 60.00%in the control group(P<0.05).After 14 days of treatment,the scores of abdominal pain,bloating,nausea,poor appetite and digestion,mental fatigue and lack of strength,unformed stool and pale facial complexion in the two groups were lower than those five days after surgery(P<0.05).The above seven TCM syndrome scores in the study group were lower than those in the control group(P<0.05).After 14 days of treatment,the numbers of Lactobacillus and Bifidobacterium in the two groups were increased when compared with those five days after surgery(P<0.05),and the number of Enterococcus faecalis and Escherichia coli were reduced when compared with those five days after surgery(P<0.05).The numbers of Lactobacillus and Bifidobacterium in the study group were more than those in the control group(P<0.05),and the numbers of Enterococcus faecalis and Escherichia coli were less than those in the control group(P<0.05).After 14 days of treatment,the levels of albumin and total protein in the two groups were higher than those five days after surgery(P<0.05),and the levels of albumin and total protein in the study group were higher than those in the control group(P<0.05).During the treatment,the incidence of complications was 8.89%in the study group and 13.33%in the control group,there being no significance in the difference(P>0.05).Conclusion:The combination use of Fuzheng Jiedu Prescription and Bifidobacterium Triple Viable Tablets can improve the intestinal microecology and nutritive indexes of patients with syndrome of spleen-stomach qi deficiency after surgery of gastric cancer,and effectively relieve the clinical symptoms,and its curative effect is better than that of Bifidobacterium Triple Viable Tablets alone.