升阳益胃汤治疗胃癌根治术后脾虚型胃肠功能障碍临床研究

Clinical Study on Shengyang Yiwei Decoction(升阳益胃汤)on Spleen Deficiency Type Postoperative Gastrointestinal Dysfunction(POGD)After Radical Gastrectomy

目的:观察升阳益胃汤对胃癌根治术后脾虚型胃肠功能障碍(POGD)患者的临床疗效。方法:选取胃癌根治术后脾虚型POGD患者90例,采用随机数字表法将其分成治疗组与对照组各45例。观察升阳益胃汤治疗胃癌根治术后胃肠功能障碍的临床疗效、中医证候积分、Karnofsky功能状态评分(KPS)、检测T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))及癌胚抗原(CEA)、糖类抗原-199(CA-199)、糖类抗原-724(CA-724)肿瘤标志物水平,并对其有效性及安全性进行评估。结果:与对照组比较,治疗组在食少纳呆、食后腹胀、大便异常和排便无力症状评分方面均呈下降趋势,且治疗组的中医证候改善明显优于对照组(P<0.05),治疗组中医证候临床总有效率为44.57%,优于对照组37.34%,两组疗效比较,差异有统计学意义;两组治疗前后KPS评分比较治疗组的KPS评分明显优于对照组(P<0.05);治疗组CEA、CA-199、CA-724水平较对照组更为明显(P<0.01);免疫学指标表达水平显示治疗组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)表达水平较对照组显著增高(P<0.05),治疗组CD8^(+)表达水平降低,且下降幅度明显大于对照组(P<0.01)。结论:升阳益胃汤可明显改善胃癌根治术后脾虚型POGD患者的中医证候积分、体力状况、免疫功能,降低肿瘤标志物水平。

Objective:To observe the clinical effect of Shengyang Yiwei Decoction(升阳益胃汤)on patients with spleen deficiency type postoperative gastrointestinal dysfunction(POGD)after radical gastrectomy.Methods:In this study,a total of 90 patients with spleen deficiency type POGD after radical gastrectomy were selected to be treated with Shengyang Yiwei Decoction and were divided into two groups by using the randomized numerical table method,with 45 patients in each group.Both groups underwent intervention therapy to observe the clinical efficacy of Shengyang Yiwei Decoction in treating spleen deficiency type POGD after radical gastrectomy,the changes of traditional Chinese medicine symptom score,Karnofsky functional status score(KPS),and the levels of T-lymphocyte subsets(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))and the levels of tumor markers of CEA,CA-199,and CA-724 were detected,and their efficacy and safety were evaluated.Results:Compared with the control group,the treatment group showed a decreasing trend in the symptom scores of hypophagia,postprandial bloating,stool abnormality and defecation weakness,and the improvement of TCM symptoms in the treatment group was significantly better than that in the control group(P<0.05),and the total clinical effectiveness rate of TCM symptoms in the treatment group was 44.57%,which was better than that in the control group 37.34%,the difference was statistically significant between the two group;After treatment,the KPS score of the treatment group was significantly better than that of the control group(P<0.05).The level of CEA,CA-199 and CA-724 decreased significantly in the treatment group compared with that of the control group(P<0.01).The expression levels of the two groups showed that the expression levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the treatment group were significantly higher than those in the control group(P<0.05),while the expression level of CD8^(+)in the treatment group was decreased,and the decreasing range in the treatment group was significantly greater than that in the control group(P<0.01).Conclusions:Shengyang Yiwei Decoction can significantly improve the TCM syndrome score,physical status evaluation,immune function,reduce the level of tumor markers in patients with with spleen deficiency type postoperative gastrointestinal dysfunction after radical gastrectomy.