健脾理气汤灌肠对胃癌术后并发胃瘫综合征患者细胞免疫状况、胃肠功能恢复及肠内营养状况的影响

目的观察健脾理气汤灌肠对胃癌术后并发胃瘫综合征患者细胞免疫状况、胃肠功能恢复及肠内营养状况的影响。方法将90例胃癌术后并发胃瘫综合征患者按随机数字表法分为2组。对照组45例采用常规支持治疗和盐酸甲氧氯普胺注射液肌肉注射治疗;治疗组45例在对照组治疗基础上采用健脾理气汤灌肠治疗。2组疗程均为2周。比较2组临床疗效,治疗前后中医证候积分、细胞免疫指标T淋巴细胞亚群(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)和自然杀伤(NK)细胞]、胃肠功能指标(胃肠减压引流量、首次排气时间、腹胀缓解时间、正常进食时间)和肠内营养指标转铁蛋白(TRF)、血清前白蛋白(PA)、血清总蛋白(TP)、血红蛋白(Hb)],并统计不良反应情况。结果治疗组总有效率88.89%(40/45),对照组总有效率71.11%(32/45),治疗组疗效优于对照组(P<0.05)。治疗后2组CD3^+、CD4^+、CD4^+/CD8^+、NK细胞均升高(P<0.05),CD8^+均降低(P<0.05);治疗组治疗后CD3^+、CD4^+、CD4^+/CD8^+、NK细胞均高于对照组(P<0.05),CD8^+低于对照组(P<0.05)。治疗组胃肠减压引流量、首次排气时间、腹胀缓解时间、正常进食时间均低于对照组(P<0.05)。治疗后2组TRF、PA、TP、Hb均升高(P<0.05),治疗组治疗后TRF、PA、TP、Hb均高于对照组(P<0.05)。治疗后2组各项中医证候评分及总分均降低(P<0.05),治疗组治疗后各项中医证候评分及总分均低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论健脾理气汤能够显著改善胃癌术后并发胃瘫综合征患者临床症状,提高细胞免疫功能和营养状况,促进胃肠功能恢复,值得推广应用。

Effect of Jianpi Liqi decoction enema on cellular immune status,gastrointestinal function recovery and enter-al nutrition status in patients with gastroparesis syndrome after gastric cancer operation

Objective To observe the effect of Jianpi Liqi decoction enema on cellular immune status,gastrointestinal function recovery and enteral nutrition status in patients with gastroparesis syndrome after gastric cancer operation.Methods 90 patients with gastroparesis syndrome after gastric cancer operation were divided into two groups according to random number table method.45 cases in control group were treated by routine support therapy and intramuscular injection of metoclopramide hydrochloride.45 cases in treatment group were treated by enema with Jianpi Liqi decoction on the basis of the control group.Both group were treated for two weeks.The clinical efficacy,TCM syndrome score,cellular immune indexesT lymphocyte subsets(CD3^+,CD4^+,CD8^+,CD4^+/CD8^+)and natural killer(NK)cells],gastrointestinal function index(gastrointestinal decompression and drainage,first exhaust time,abdominal distension relief time,normal eating time)and enteral nutrition indexestransferrin(TRF),prealbumin(PA),total serum protein(TP),hemoglobin(Hb)]were compared before and after treatment between two groups,and the adverse reactions were counted.Results The total effective rate was 88.89%(40/45)in treatment group and 71.11%(32/45)in control group.The clinical curative effect of the treatment group was better than that of the control group(P<0.05).After treatment,CD3^+,CD4^+,CD4^+/CD8^+,NK cells were increased in two groups(P<0.05),CD8^+was decreased(P<0.05).After treatment,CD3^+,CD4^+,CD4^+/CD8^+,NK cells in the treatment group were higher than those in the control group(P<0.05),CD8^+was lower than that in the control group(P<0.05).The gastrointestinal decompression and drainage,first exhaust time,abdominal distension relief time,normal eating time in the treatment group were lower than those in the control group(P<0.05).After treatment,TRF,PA,TP,Hb were all increased in the two groups(P<0.05),and TRF,PA,TP,Hb in the treatment group were higher than those in the control group(P<0.05).After treatment,the scores and total scores of TCM syndromes in the two groups were decreased(P<0.05),and those in the treatment group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Jianpi Liqi decoction can significantly improve the clinical symptoms of patients with gastric paralysis syndrome after gastric cancer operation,improve cellular immune function and nutritional status,and promote gastrointestinal function recovery.It is worth popularizing and applying.