早期肠内应用四君子汤对消化道肿瘤术后患者免疫功能的影响

目的评价早期肠内应用四君子汤对消化道肿瘤患者手术创伤后免疫功能的影响：方法92例消化道恶性肿瘤手术患者随机分为常规肠内营养组（简称对照组）和四君子汤干预肠内营养组（简称研究组）。两组均从手术后第1天开始等热量、等氮肠内营养支持1周，研究组同时以四君子汤治疗1周：于手术前1天，手术后第1天清晨，研究结束时检测血清细胞因子白细胞介素1（IL-1）、白细胞介素2（IL-2）、白细胞介素6（IL-6）及肿瘤坏死因子α（TNF-α）浓度，外周血淋巴细胞总数，B淋巴细胞数，T淋巴细胞及亚群（CD3、CD4、CD8及CD4／CD8），免疫球蛋白（IgA、IgG、IgM）浓度，血清C反应蛋白（CRP）浓度。结果研究结束时，研究组IgA、IgG、IgM浓度，外周血淋巴细胞总数，CD3、CD4及CD4／CDR均明显高于对照组（P〈0．05）；血清IL-2也明显高于对照组（P〈0．05），而IL-6、TNF-α浓度及CRP水平则明显低于对照组（P〈0．05）。结论胃肠道术后患者早期肠内营养基础上加用四君子汤治疗可以减轻患者术后的应激和炎症反应程度，增强机体免疫功能。

Effects of Early Intestinal Application of Sijunzi Decoction on Immune Function in Post-Operational Patients of Gastrointestinal Tumor

OBJECTIVE: To assess the effects of early intestinal application of sijunzi decoction (SJZD) on the immune function in post-operational patients of gastrointestinal tumor. METHODS: Ninety-two patients with malignant gastrointestinal tumor were randomly divided into two groups. Patients in both groups were given the isocaloric and isonitrogenous enteral nutritional support starting from the first day after operation for 1 week, but to the tested group, SJZD was given additionally. The concentration of serum cytokines such as interleukin-1 (IL-1), interleukin-2 (IL-2), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha), the peripheral blood cell counts of total lymphocyte, T-lymphocyte, B lymphocyte, and T lymphocyte subsets (CD3, CD4, CD8, CD4/CD8) as well as the levels of IgA, IgG, IGM and C-reactive protein (CRP) were measured on the day before operation, the first morning after operation and at the end of study. RESULTS: At the end of the study, the concentration of IgA, IgG, 1gM, number of total lymphocyte, CD3, CD4 and CD4 lCD8, and serum IL-2 were obviously higher (P < 0.05), and levels of IL-6, TNF-alpha and CRP were obviously lower in the tested group than those in the control group (P < 0.05). CONCLUSION: Early application of SJZD on the base of enteral nutritional therapy can lessen the degree of post-operational stress and inflammatory response, and enhance the immune function of patients.