胃癌术后八珍汤加减辅助肠内营养对生长激素、营养状况及免疫功能的影响

Effects of Modified Bazhen Decoction in Assistant with Enteral Nutrition on the Growth Hormone, the Nutritional State, and the Immune Function in Patients with Gastric Cancer after Operation

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中文关键词: 胃癌八珍汤加减肠内营养生长激素水平营养状况免疫功能

英文关键词:gastric cancer modified Bazhen Decoction enteral nutrition growth hormone the nutritional state immune function

基金项目:

作者	单位
王宏星	无锡市中西医结合医院临床营养科
李建平	无锡市中西医结合医院消化外科

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中文摘要:

目的观察胃癌患者术后使用中药八珍汤加减辅助肠内营养(enteral nutrition,EN)对生长激素、营养状况及免疫功能的影响。方法采用前瞻性、随机、单盲、对照研究,经筛选后将88例胃癌手术患者按抽签法随机分为肠外营养组(27例)、肠内营养组(30例)和综合组(八珍汤加减辅助肠内营养,31例)。肠外营养组术后当天即给予等热量、等氮肠外营养支持至第9天;另外两组于手术后第2天开始给予等热量、等氮肠内营养支持至第9天;综合组于术后第2～9天另加八珍汤加减100mL管饲。3组均于术前1天,术后第1天和第10天分别检测生长激素(GH)水平,IgA、IgG、CD4+、CD8+、CD4+/CD8+等免疫指标及血清白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TRF)等营养指标。结果术后3组患者IgA、IgG、CD4+、CD4+/CD8+水平和ALB、PA及TRF均较术前有所下降,差异有统计学意义(P<0.05)。术后第10天,肠内营养组和综合组GH、ALB、PA、TRF和IgA、IgG、CD4+、CD4+/CD8+均较肠外营养组提高,差异有统计学意义(P<0.05);且综合组上述指标又较肠内营养组提高(P<0.05)。结论胃癌术后中药八珍汤加减辅助肠内营养能进一步促进GH水平提高,改善机体营养状况和免疫功能情况。

英文摘要:

Objective To observe the effects of modified Bazhen Decoction (BZD) in assistant with enteral nutrition (EN) on the growth hormone, the nutritional state, and the immune function in patients with gastric cancer after operation. Methods The prospective, random, single-blinded, controlled clinical trial was adopted. 88 patients receiving gastric cancer operation were randomly assigned to the parenteral nutrition group (Group A, 27 cases), the EN group (Group B, 30 cases), and the comprehensive group (Group C, BZD in assistant with EN, 31 cases). Isocaloric and isonitrogonous parenteral nutritional support was given to patients in Group A from the operation day to the ninth day. Isocaloric and isonitrogonous EN was given to patients in Group B and C from the second day of operation till the ninth day. 100 mL BZD was nasal fed to patients in Group C during the second day to the ninth day after operation. The levels of the growth hormone, immune indices such as IgA, IgG, CD+4, CD+8, and CD+4/CD+8, etc., and nutritional indices such as seral albumin, prealbumin, transferrin, etc. were detected in the three groups one day before operation, on the 1st day after operation, and on the tenth day after operation. Results The levels of IgA, IgG, CD+4 and CD+4/CD+8, seral albumin, prealbumin, transferrin decreased more than before operation in the three groups, with statistical difference (P<0.05). On the tenth day after operation, all indices in Group B and C were somewhat improved, showing statistical difference when compared with those in Group A (P<0.05). Besides, the aforesaid indices were higher in Group C than in Group B (P<0.05). Conclusions Modified BZD in assistant with EN could further promote the elevation of the growth hormone levels. Besides, it could further improve the nutrition state and the immune function.

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