四君子汤联合肠内营养治疗胃癌脾虚证临床研究  

Clinical Study on Sijunzi Decoction Combined Enteral Nutrition in the Treatment of Gastric Cancer with Spleen Deficiency Syndrome

作　　者：吴颖仪 杨洁 周卫平[2] WU Yingyi;YANG Jie;ZHOU Weiping(Xiaolan Hospital Affiliated to Southern Medical University,Zhongshan 528415,China;Hainan General Hospital,Haikou 570311,China)

机构地区：[1]南方医科大学附属小榄医院,中山528415 [2]海南省人民医院,海口570311

出　　处：《世界中医药》2021年第7期1104-1108,共5页World Chinese Medicine

基　　金：海南省自然科学基金项目(813203)。

摘　　要：目的:探究四君子汤联合肠内营养治疗脾虚证胃癌患者的临床效果。方法:选取2016年3月至2017年2月南方医科大学附属小榄医院收治的胃癌患者87例作为研究对象,随机分成为对照组(n=43)和观察组(n=44),对照组行肠内营养支持,观察组行四君子汤联合肠内营养支持。观察2组营养指标、T淋巴细胞亚群、肠道菌群以及治疗效果。结果:2组患者术后8 d较术后1 d的血清白蛋白(ALB)、前白蛋白(PA)和转铁蛋白(TRF)均显著升高(P<0.05);与术后8 d比较,观察组ALB、PA、TFN均显著高于对照组(P<0.05)。2组患者术后8 d较术后1 d的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均显著升高(P<0.05);观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均显著高于对照组(P<0.05)。治疗后,观察组拟杆菌、真杆菌、酵母菌、消化球菌、乳酸杆菌、双歧杆菌显著高于对照组(P<0.05);小梭菌、肠球菌、肠杆菌显著低于对照组(P<0.05),观察组总有效率显著高于对照组(P<0.05)。结论:对脾虚证胃癌患者应用四君子汤联合肠内营养,能够有效提高患者营养状态和免疫功能,并对肠道菌群的平衡性形成一定的影响,效果较好。Objective:To explore the clinical effects of Sijunzi Decoction combined with enteral nutrition in the treatment of gastric cancer with spleen deficiency syndrome.Methods:A total of 87 patients with gastric cancer patients admitted to Xiaolan Hospital Affiliated to Southern Medical University from March 2016 to February 2017,were selected as the research objects and were randomly divided into 2 groups.The control group(43 cases)received enteral nutrition support,and the observation group(44 cases)received Sijunzi Decoction combined with enteral nutrition support.The nutrition index,T lymphocyte subgroup,intestinal flora,and therapeutic effects of the 2 groups were observed.Results:There was a significant increase of ALB,PA,and TRF in both groups 8 days after surgery compared with 1 day after surgery(P<0.05).ALB,PA and TFN of the observation group were significantly higher than those of the control group(P<0.05)8 days after surgery.Both group of patients had a significant increase in CD3^(+),CD4^(+),CD4^(+)/CD8^(+)(P<0.05)8 days after surgery compared with 1 day after surgery.It was observed that CD3^(+),CD4^(+),CD4^(+)/CD8^(+)of the observation group were significantly higher than those of the control group(P<0.05).After treatment,bacteroides,eubacteria,yeast,peptococcus,lactobacillus,and bifidobacterium in the observation group were significantly higher than those in the control group(P<0.05);clostridium parvum,enterococcus,and enterobacter were significantly lower than those in the control group(P<0.05),and the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Application of Sijunzi Decoction combined with enteral nutrition in the treatment of gastric cancer patients with spleen deficiency syndrome can effectively improve the nutritional status and immune function of patients.And it has a certain effect on the balance of the intestinal flora.The treatment is superior.

关 键 词：四君子汤 脾虚证 胃癌 免疫功能 肠道菌群 营养状态 T细胞亚群 肠内营养 

分 类 号：R256.3[医药卫生—中医内科学] R735.2[医药卫生—中医学]