大黄联合肠内营养对胃癌围手术期患者外周血C反应蛋白和白细胞介素6水平的影响  

Effect of Rhubarb Combined with Enteral Nutrition on C-reactive Protein and Interleukin-6 in Peripheral Blood of Patients with Gastric Cancer during Perioperative Period

作　　者：王华[1] 郭立杰[1] 吴彬[1] 宋华荣[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,上海200032

出　　处：《中国中西医结合杂志》2008年第2期101-104,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：上海市卫生局基金资助课题(No.02-4008)

摘　　要：目的观察应用中药大黄和肠内营养对胃癌围手术期患者外周血C反应蛋白(C-reactive pro-tein,CRP)、白细胞介素6(interleukin6,IL-6)水平的影响。方法将56例胃癌围手术期患者随机分为对照组20例,肠内营养组21例,大黄加肠内营养组15例。对照组术后常规补液的同时实施肠外营养支持;肠内营养组术后常规补液的同时术后42h开始给予肠内营养液能全力鼻饲管滴入,一直持续到术后第8天;大黄加肠内营养组患者术前1天应用大黄液100mL(10g),术后18h、42h各用大黄液50mL(5g),同时给予肠内营养液能全力。所有研究对象分别于手术前1天、手术后第1、3、7天检测血清CRP、IL-6。结果3组患者术后均有急性炎症反应的发生,但大黄加肠内营养组术后第7天血浆CRP水平〔(12.67±4.28)mg/L〕和IL-6水平〔(18.17±11.10)mg/L〕均明显下降,与对照组〔(19.72±9.73)mg/L、(20.44±6.32)mg/L〕及肠内营养组〔(21.27±10.46)mg/L、(20.29±7.79)mg/L〕比较,差异均有统计学意义(P<0.05);大黄加肠内营养组肠鸣音的恢复较非大黄组提前。结论胃癌患者围手术期应用大黄可以有效降低外周血CRP、IL-6水平,缓解手术创伤引起的急性炎症反应,促进术后胃肠道功能恢复,有利于实施术后肠内营养支持。Objective To observe the effects of rhubarb and enteral nutrition on C-reactive protein （CRP） and interleukin-6 （IL-6） in peripheral blood of patients with gastric cancer during perioperative period. Methods Fifty-six patients with gastric cancer were randomly assigned to three groups. The 20 patients in Group A were given conventional fluid supplement and parenteral nutrition; the 21 patients in Group B were given conven- tional fluid supplement and enteral nutrition via nasal feeding starting from the 42nd hour to the 8th day after operation; and the 15 patients in Group C were treated, besides the same fluid supplement and enteral nutrition as that for Group B, with additional three times of 10% rhubarb liquid medication, given at the day before operation （100 mL）, and the 18th and 42th hour post-operation （50 mL in each time）. Serum levels of CRP and IL-6 of all patients were measured at different time points, i.e. the day before operation （ T0）, the 1 st （ T1 ）, 3rd （T2） and 7th day （33） after operation. Results Acute inflammatory reaction happened in all the patients. However, the plasma level of CRP and IL-6 in Group C at T3 （12. 67 ±4. 28 mg/L and 18. 17 ± 11.10 mg/L） was significantly lower than those in Group A （ 19. 72 ±9. 73 mg/L and 20. 44 ±6. 32 mg/L） and Group B （21.27 ± 10. 46 mg/L and 20. 29 ± 7.79 mg/L）, respectively （ P 〈 0. 05 ）. And the recovery time of borborgmus in Group C were the shortest among the three groups. Conclusion Applying rhubarb on gastric cancer patients during perioperative period can effectively decrease the levels of CRP and IL-6 in peripheral blood, alleviate acute inflammatory reaction caused by operative trauma, promote the recovery of postoperative gastrointestinal motility and be beneficial for the supplement of enteral nutrition.

关 键 词：胃癌 大黄 C反应蛋白 白细胞介素-6 

分 类 号：R735.2[医药卫生—肿瘤]