益气健脾汤对腹腔镜直肠癌术后患者炎症反应和免疫功能以及营养状态的影响  

Effects of Yiqi Jianpi decoction on inflammatory reaction,immune function and nutritional status of patients after laparoscopic rectal cancer surgery

作　　者：刘任林 周录平 邓文胜 宋俊 何建飞 肖永娟[4] Liu Renlin;Zhou Luping;Deng Wensheng;Song Jun;He Jianfei;Xiao Yongjuan(Department of Anorectal Surgery,Pingxiang People's Hospital,Pingxiang 337055,Jiangxi,China;Department of General Surgery,Pingxiang Second People's Hospital,Pingxiang 337000,Jiangxi,China;Department of General Surgery,Pingxiang People's Hospital,Pingxiang 337055,Jiangxi,China;Department of Chinese Medicine Rehabilitation,Pingxiang People's Hospital,Pingxiang 337055,Jiangxi,China)

机构地区：[1]萍乡市人民医院肛肠外科,江西萍乡337055 [2]萍乡市第二人民医院普通外科,江西萍乡337000 [3]萍乡市人民医院普通外科,江西萍乡337055 [4]萍乡市人民医院中医康复科,江西萍乡337055

出　　处：《中国中西医结合急救杂志》2019年第4期448-451,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：江西省科技计划项目(20122BBG70123).

摘　　要：目的观察益气健脾汤对腹腔镜直肠癌术后患者炎症反应、免疫功能和营养状态的影响.方法选择2017年6月至2019年3月在萍乡市人民医院就诊的82例腹腔镜直肠癌术后患者,将患者按是否加用中药治疗分为西医治疗对照组和中西医联合治疗组,每组41例.西医治疗对照组给予对症基础治疗;中西医联合治疗组在西医常规治疗基础上加用益气健脾汤(组成:白花蛇舌草、仙鹤草、黄芪各30g,党参、灵芝各20g,白术、茯苓、夏枯草各15g,半夏9g,甘草6g),水煎取汁,每日2次、每次150mL,21d为1个疗程,用药1个疗程后评价临床疗效.观察两组患者治疗前后中医证候积分、简明健康状况调查量表(SF-36)评分、炎症指标、免疫功能及营养状况的变化.结果两组治疗后中医证候积分、C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、CD8^+水平均较治疗前显著降低,SF-36评分、CD4^+、CD4^+/CD8^+、转铁蛋白(TRF)、白蛋白(Alb)水平均较治疗前显著升高(均P<0.05),且以中西医联合治疗组上述指标的变化较西医治疗对照组更显著〔中医证候积分(分):3.79±2.22比6.86±2.02,SF-36评分(分):75.18±4.13比64.17±4.01,CRP(mg/L):4.54±1.31比5.71±2.21,IL-6(μg/L):20.21±2.21比26.12±2.13,TNF-α(μg/L):33.04±4.56比36.41±3.23,CD4^+:0.37±0.03比0.35±0.03,CD8^+:0.25±0.03比0.28±0.03,CD4^+/CD8^+:1.51±0.39比1.19±0.37,TRF(g/L):3.05±0.41比2.28±0.42,Alb(g/L):43.88±2.28比39.86±2.03,均P<0.05〕.结论益气健脾汤治疗腹腔镜直肠癌术后患者,可有效促进肠胃功能恢复,降低炎症反应,提高免疫功能,改善临床预后.Objective To explore the effects of Yiqi Jianpi decoction on inflammatory reaction,immune function and nutritional status in patients after surgery of laparoscopic rectal cancer.Methods Eighty-two patients with post-operative laparoscopic rectal cancer resection admitted to Pingxiang People's Hospital from June 2017 to March 2019 were enrolled,and according to whether traditional Chinese medicine(TCM)was used or not,they were divided into a western medicine treatment control group(control group)and a combined traditional Chinese and western medicine treatment group(combined group),41 cases in each group.The control group was treated with symptomatic conventional western therapy,while the combined group was additionally treated with Yiqi Jianpi decoction based on the conventional western treatment as in the control group;the composition of the decoction:hedyotis herba,herba agrimoniae,radix astragali each 30 g;radix codonopsis,ganoderma lucidum each 20 g;rizoma atractylodes,poria cocos and prunella chinensis 15 g each;pinellia ternata 9 g,licorice root 6 g;all the above ingredients were together boiled with water and the fluid(decoction)was filtered,150 mL once orally taken,twice a day,21 days constituting one therapeutic course,and the clinical efficacy was evaluated after 1 course of therapy.The changes of TCM syndrome score,simple health situation scale(SF-36)score,inflammatory indexes,immune function and nutritional status of the two groups were observed before and after treatment.Results After treatment,the levels of TCM syndrome score,C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and CD8^+in the two groups were significantly lower than those before treatment,while the levels of SF-36 score,CD4^+,CD4^+/CD8^+,transferrin(TRF)and albumin(Alb)were significantly higher than those before treatment(all P<0.05),and the degree of changes in the combined group were more significant than those in control group[TCM syndrome score:3.79±2.22 vs.6.86±2.02,SF-36 score:75.18±4.13 vs.64.17±4.

关 键 词：直肠癌 腹腔镜 益气健脾汤 炎症反应 免疫功能 

分 类 号：R725.6[医药卫生—儿科]