四君子汤联合肠内营养对胃癌手术患者T细胞亚群及营养状况影响.docVIP

四君子汤联合肠内营养对胃癌手术患者T细胞亚群及营养状况影响 　 作者：蔡骏, 王华, 周胜, 吴彬, 宋华荣, 宣正荣 【关键词】 胃癌; 四君子汤; T细胞亚群; 肠道营养; 营养状况 Objective: To observe the effect of perioperative application of Sijunzi Decoction and enteral nutrition on T-cell subsets and nutritional status in patients with gastric cancer after operation. Methods: In this prospective, single-blinded, controlled clinical trial, fifty-nine patients with gastric cancer were randomly divided into three groups: control group (n=20) and two study groups (group A, n=21; group B, n=18). Sjunzi Decoction (100 ml) was administered via nasogastric tube to the patients in the study group B from the second postoperation day to the 9th postoperation day. Patients in the two study groups were given an isocaloric and isonitrogonous enteral diet, which was started on the second day after operation, and continued for eight days. Patients in the control group were given an isocaloric and isonitrogonous parenteral diet for 9 days. All variables of nutritional status such as serum albumin (ALB), prealbumin (PA), transferrin (TRF) and T-cell subsets were measured one day before operation, and one day and 10 days after operation. Results: All the nutritional variables and the levels of CD3+, CD4+, CD4+/CD8+ were decreased significantly after operation. Ten days after operation, T-cell subsets and nutritional variables in the two study groups were increased as compare with the control group. The levels of ALB, TRF and T-cell subsets in the study group B were increased significantly as compared with the study group A (Plt;0.05). Conclusion: Enteral nutrition assisted with Sijunzi Decoction can positively improve and optimize cellular immune function and nutritional status in the patients with gastric cancer after operation. Keywords: stomach cancer; Sijunzi Decoction; T-cell subsets; enteral nutrition; nutritional status 胃癌患者在围手术期常常伴有营养不良和免疫功能低下，选择合适的营养支持方法及时纠正营养不良，提高机体的免疫功能是术后治疗的关键。针对胃癌患者围手术期机体代谢的特点，本研究在术后常规肠内营养治疗的同时，辅助应用具有免疫药理作用的中药四君子汤［1］，有效地提高了患者术后的