肠内免疫营养对食管癌化疗患者脾虚证候及免疫功能影响的临床研究  

Clinical study of enteral immunonutrition on chemotherapy-induced spleen deficiency syndrome in patients with esophageal cancer

作　　者：姚庆华[1] 王赟[2] 谷建钟[1] 傅婷[2] 汪潞[2] 

机构地区：[1]浙江省中医院,杭州310006 [2]浙江中医药大学第一临床医学院,杭州310053

出　　处：《中华中医药杂志》2014年第7期2321-2325,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：浙江省中医药科技计划项目(No.2007CD148)~~

摘　　要：目的:评价肠内免疫营养对食管癌患者化疗所致脾虚证候及免疫功能的影响。方法:60例食管癌化疗病人随机分为空白对照组、肠内免疫营养组和中药组3组,分析各组治疗后脾虚状态、血液毒性、营养状态及免疫状态的变化。结果:脾虚状态:3组化疗后脾虚积分均有升高,以空白对照组最明显(P<0.05),肠内免疫营养组和中药组无显著差异;血液学毒性:与空白对照组比,肠内免疫营养组可降低血液毒性发生率(P<0.05);中药组Ⅲ度以上血液学毒性的发生率无统计学差异;营养状态:化疗后第7天各组血清前白蛋白、转铁蛋白较化疗前均显著降低(P<0.05),第14、21天肠内免疫营养组血清前白蛋白、转铁蛋白优于空白对照组和中药组(P<0.05);免疫状态:化疗前后辅助性T细胞(CD4+)及CD4+/CD8+比值较空白对照组明显下降(P<0.05);肠内免疫营养组及中药组较化疗前两组数值均上升(P<0.05)。结论:化疗可导致食管癌患者出现或加重脾虚证;肠内免疫营养可改善患者脾虚证,减轻血液毒性的发生率,提高患者的营养状态,增强患者机体免疫功能。Objective： Enteral immunonutrition was used on esophageal cancer patients to evaluate the influence on chemotherapy-induced spleen deficiency syndrome. Methods： 60 cases of esophageal cancer chemotherapy patients were randomly divided into blank control group, enteral immunonutrition group and Chinese medicine group. The changes of spleen deficiency syndrome scores, hematologic toxicity, nutritional status and T lymphocyte subsets after treatment in each group were evaluated. Results： Spleen deficiency syndrome scores were all increased in three groups,with signii cantly enhanced in blank control group（P〈0.05）. There was no signii cant dif erence between enteral immunonutrition group and Chinese medicine group. Hematologic toxicity： Enteral nutrition formulations can reduce the incidence of hematologic toxicity, with signii cantly dif erence（P〈0.05） compared with the blank control group; Chinese medicine group had no signii cant dif erence in the incidence of Grade Ⅲ hematologic toxicity. Nutritional status： Compared with the levels before chemotherapy, serum prealbumin and transferrinwere signii cantly decreased in all 3 groups on the 7th day after chemotherapy（P〈0.05）, while enteral immunonutrition group was signii cantly increased（P〈0.05） than other groups on 14 th and 21 th days. T lymphocyte subsets： After chemotherapy, T helper cells（CD＋＋4） and ratio of CD4, CD＋4/CD＋8 were signii cantly decreased in blank control group（P〈0.05）, on the contrary, they were signii cantly increased in other two groups（P〈0.05）. Conclusion： Antineoplastic chemotherapy could inl uence the syndromes of traditional Chinese Medicine, cause or exacerbate spleen deficiency syndrome in patients with esophageal cancer. Enteral immunonutrition can relieve symptoms of spleen deficiency syndrome, reduce the incidence of hematologic toxicity, improve the nutritional status and enhance immunity of patients.

关 键 词：化疗 脾虚证 肠内免疫营养 

分 类 号：R735.1[医药卫生—肿瘤]