Effect of modified ShengYangYiwei decoction on painless gastroscopy and gastrointestinal and immune function in gastric cancer patients

BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects of gastric cancer patients.The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort.In clinical work,the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose;the application of opioid drugs often causes gastrointestinal reactions,such as nausea,vomiting and delayed gastrointestinal function recovery,after examination.These adverse effects can seriously affect the quality of life of patients.AIM To observe the effect of modified ShengYangYiwei decoction on gastrointestinal function,related complications and immune function in patients with gastric cancer during and after painless gastroscopy.METHODS A total of 106 patients with gastric cancer,who were selected from January 2022 to September 2022 in Xiamen Traditional Chinese Medicine Hospital for painless gastroscopy,were randomly divided into a treatment group(n=56)and a control group(n=50).Before the examination,all patients fasted for 8 h,provided their health education,and confirmed if there were contraindications to anesthesia and gastroscopy.During the examination,the patients were placed in the left decubitus position,the patients were given oxygen through a nasal catheter(6 L/min),the welling needle was opened for the venous channel,and a multifunction detector was connected for monitoring electrocardiogram,oxygen saturation,blood pressure,etc.Naporphl and propofol propofol protocols were used for routine anesthesia.Before anesthesia administration,the patients underwent several deep breathing exercises,received intravenous nalbuphine[0.nalbuphine(0.025 mg/kg)],followed by intravenous propofol[1.propofol(1.5 mg/kg)]until the palpebral reflex disappeared,and after no response,gastroscopy was performed.If palpebral reflex disappeared,and after no response,gastroscopy was performed.If any patient developed movement,frowning,or hemodynamic changes during the operation(heart rate changes during the operation(heart rate increased to>20 beats/min,systolic blood pressure increased to>20%of the base value),additional propofol[0.propofol(0.5 mg/kg)]was added until the patient was sedated again.The patients in the treatment group began to take the preventive intervention of Modified ShengYangYiwei decoction one week before the examination,while the patients in the control group received routine gastrointestinal endoscopy.The patients in the two groups were examined by conventional painless gastroscopy,and the characteristics of the painless gastroscopies of the patients in the two groups were recorded and compared.These characteristics included the total dosage of propofol during the examination,the incidence of complications during the operation,the time of patients'awakening,the time of independent activities,and the gastrointestinal function of the patients after examination,such as the incidence of reactions such as malignant vomiting,abdominal distension and abdominal pain,as well as the differences in the levels of various immunological indicators and inflammatory factors before anesthesia induction(T0),after conscious extubation(T1)and 24 h after surgery(T2).RESULTS There was no difference in the patients’general information,American Society of Anesthesiologist classification or operation time between the two groups before treatment.In terms of painless gastroscopy,the total dosage of propofol in the treatment group was lower than that in the control group(P<0.05),and the time of awakening and autonomous activity was significantly faster than that in the control group(P<0.05).During the examination,the incidence of hypoxemia,hypotension and hiccups in the treatment group was significantly lower than that in the control group(P<0.01).In terms of gastrointestinal function,the incidences of nausea,vomiting,abdominal distension and abdominal pain in the treatment group after examination were significantly lower than those in the control group(P<0.01).In terms of immune function,in both groups,the number of CD4+and CD8+cells decreased significantly(P<0.05),and the number of natural killer cells increased significantly(P<0.05)at T1 and T2,compared with T0.The number of CD4+and CD8+cells in the treatment group at the T1 and T2 time points was higher than that in the control group(P<0.05),while the number of natural killer cells was lower than that in the control group(P<0.05).In terms of inflammatory factors,compared with T0,the levels of interleukin(IL)-6 and tumor necrosis factor-alpha in patients in the two groups at T1 and T2 increased significantly and then decreased(P<0.05).The level of IL-6 at T1 and T2 in the treatment group was lower than that in the control group(P<0.05).CONCLUSION The preoperative use of modified ShengYangYiwei decoction can optimize the anesthesia program during painless gastroscopy,improve the gastrointestinal function of patients after the operation,reduce the occurrence of examination-related complications.

升阳益胃汤加减治疗腹泻型肠易激综合征的疗效

目的探讨升阳益胃汤加减治疗腹泻型肠易激综合征的疗效。方法 50例腹泻型肠易激综合征患者按住院单双号顺序分为25例研究组和25例对照组。研究组接受升阳益胃汤加减治疗,对照组接受西药治疗。结果研究组和对照组腹泻型肠易激综合征的治疗有效率分别为96%、84%,差异比较有统计学意义(P<0.05)。结论升阳益胃汤加减治疗腹泻型肠易激综合征疗效肯定。

升阳益胃法辨治特发性水肿56例临床观察

目的观察升阳益胃法辨证治疗特发性水肿的临床疗效。方法将109例特发性水肿患者随机分为治疗组和对照组,治疗组给予升阳益胃汤加减治疗;对照组给予氢氯噻氢联合安体舒通治疗,两组均以2周为1疗程,两个疗程结束后统计近期治疗效果和6个月后远期治疗效果。结果两组比较,近期临床有效率无明显差异(P>0.05),说明两组近期疗效相近。远期疗效方面,治疗组总有效率明显优于对照组(P<0.05)。两者相比中医治疗的远期疗效持久稳定,具有明显优势。结论升阳益胃法辨证治疗特发性水肿疗效持久稳定,值得进一步研究。

东垣升阳益胃法对类风湿关节炎治疗增效减毒作用

目的观察升阳益胃法对类风湿关节炎(RA)治疗过程中增效减毒的作用。方法选择诊断明确的150例类风湿关节炎患者,随机分为对照组75例、治疗组75例,均给予甲氨蝶呤、尼美舒利、甲泼尼龙口服,治疗组加用升阳益胃汤加减,对照组加用泮托拉唑钠胶囊,观察90d后对两组胃黏膜损伤及上消化道症状发生率进行比较,并分别在治疗前及治疗后30 d、治疗后90 d观察患者的ALT、ESR、CRP。结果治疗90 d后,治疗组胃黏膜损伤及上消化道症状发生率明显低于对照组,两组差异有统计学意义(P<0.05);两组治疗前后ALT、ESR及CRP比较,治疗组明显好于对照组,差异均有统计学意义(P<0.05)。结论升阳益胃汤能有效防治RA治疗过程中出现的消化系统副作用,同时对类风湿关节炎在改善症状、控制疾病进展等方面具有较好的疗效。

升阳益胃汤治疗慢性咳嗽的病案分析

目的分析升阳益胃汤治疗慢性咳嗽的病案。方法将本院在2016年1~7月所收诊的慢性咳嗽患者100例,按照接诊时间先后分成观察组50例,主要行升阳益胃汤治疗,对照组50例,采用传统西医进行治疗。对比两种疗法治疗效果。结果观察组治愈用时（5.41±0.59）d,对照组为（7.15±0.79）d,P〈0.05,差异具有统计学意义。观察组治疗总有效为90.00%（45/50）,对照组治疗总有效为70.00%（35/50）,P〈0.05,差异具有统计学意义。观察组无一例出现不良反应,对照组6例患者出现不良反应,P〈0.05,差异具有统计学意义。结论使用升阳益胃汤治疗对慢性咳嗽患者进行治疗,可起到提升治疗效果,降低复发率的作用。

从胃泌素-17探讨升阳益胃汤防治萎缩性胃炎的作用机制

目的:观察升阳益胃汤对慢性萎缩性胃炎患者血清胃泌素-17表达的影响,探究其防治脾胃虚弱型萎缩性胃炎的作用机制。方法:选取2017年3月~2018年3月就诊于山西省中医院门诊及住院部的脾胃虚弱型萎缩性胃炎患者60例,随机分为治疗组与对照组,治疗组予升阳益胃汤口服,对照组予胃复春片口服,12周后比较两组患者治疗前后胃泌素-17(G17)、胃蛋白酶原(PG1)指标变化及临床症状改善程度。结果:升阳益胃汤可显著升高萎缩性胃炎患者血清G17、PG1水平;改善患者纳呆、胃痛、胃胀、嘈杂不适;减轻乏力、便稀症状;缓解胃黏膜萎缩的程度。结论:升阳益胃汤防治萎缩性胃炎的作用机制可能与改善胃络循环,调节G17分泌水平有关。