大黄联合肠内营养对胃癌围手术期外周血TNF-α水平的影响  

Effect of Perioperative Application of Rhubarb and Enteral Nutrition on Peripheral Blood Tumor Necrosis Factor-α in Patients with Gastric Cancer After Operations

作　　者：郭立杰[1] 蔡骏[1] 宣正荣[1] 

机构地区：[1]上海中医药大学附属龙华医院中西医结合外科,2005级硕士研究生上海200032

出　　处：《辽宁中医杂志》2007年第7期867-869,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：上海卫生局基金资助课题(024008)

摘　　要：目的:观察胃癌患者围手术期使用中药大黄和肠内营养对TNF-α水平的影响。方法:将56名胃癌围手术期患者随机分为对照组(A组)20例;肠内营养组(B组)21例;大黄加肠内营养组(C组)15例。A组术后常规补液的同时实施肠外营养支持;B组术后常规补液的同时术后42h始给予肠内营养能全力,一直持续到术后第8天;C组病人术前1天应用大黄10g,术后18、42h分2次各5g。B组和C组术后数日内每天的液体量、热量及氮量不足部分均由肠外途径予以补足。所有研究对象分别于手术前1天、手术后第1、3、7天检测外周血肿瘤坏死因子(Tumor Necrosis Factorα,TNF-α)浓度。结果:各组患者术后均有急性炎性反应的发生,但C组术后第3、7天的TNF-α水平较A有显著下降,术后排气、排便时间和肠鸣音的恢复显著提前。术后的营养指标B组、C组患者间无明显差异。结论:胃癌患者围手术期应用大黄可以有效降低外周血TNF-α水平,缓解手术创伤引起的急性炎性反应,促进术后胃肠道功能恢复,有利于实施术后肠内营养支持。Objectives ：To observe the effect of perioperative application of Rhubarb and enteral nutrition on tumor necrosis factor-α in patients with gastric cancer after operations. Methods ： 56 patients with gastric cancer were randomly divided into three groups ： Control group （ group A） 20 persons, EN group （ group B） 21 persons and study group （ group C ） 15 persons. Group A was given conventional fluid replacement and parenteral nutrition. Group B was given conventional fluid replacement and enteral nutrition support after 42 hours of operation, keep on to 8 days after operation. Group C were given 10g Rhubarb the day before operation and 5g Rhubarb at 18, 24 hours after operation. The fluid, energy and nitrogen of group B and C was supplementary by parenteral nutrition. The variables of tumor necrosis factor - α were measured in the day before operation and on post-operation day 1,3 and 7. Gurgling sounds and postoperative complications in three groups were observed. Results ： All the patients had acute inflammatory, but the TNF - α of group C had evident decreased on postoperation day 3 and 7 compared with group A. And the recovery time of gastrointestinal motility such as borborgmus, gas elimination and defecation was shorter in the group C. Conclusion ：Rhubarb can positively cut down the TNF-α of peripheral blood ,modulate the acute inflammatory promote the recovery of postoperative gastrointestinal motility and contribute to the enteral nutrition.

关 键 词：胃癌 大黄 肿瘤坏死因子 肠内营养 

分 类 号：R273[医药卫生—中西医结合] R734.2[医药卫生—中医肿瘤科]