益气解毒汤治疗胃癌术后气虚血瘀证患者的临床研究  

Decoction of Replenishing Qi and Detoxification in the Treatment of Patients with Qi Deficiency and Blood Stasis Syndrome after Gastric Cancer Surgery

作　　者：汤伟 赵国珍 吴疆[1] 赵景芳[2] TANG Wei;ZHAO Guozhen;WU Jiang;ZHAO Jingfang(Jiangyin Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Wuxi 214400,China;Wuxi Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Wuxi 214071,China)

机构地区：[1]南京中医药大学附属江阴市中医院,江苏无锡214400 [2]南京中医药大学附属无锡市中医医院,江苏无锡214071

出　　处：《中医药学报》2023年第12期80-85,共6页Acta Chinese Medicine and Pharmacology

基　　金：江苏省卫生计生委科研基金资助项目(Y2019112)。

摘　　要：目的:观察益气解毒汤对胃癌术后气虚血瘀证患者胃肠功能恢复及辅助性T细胞1(Th1)/辅助性T细胞2(Th2)平衡的影响。方法:78例胃癌术后气虚血瘀证患者用数字奇偶法分为对照组、观察组,各39例。对照组给予肠内营养支持+常规化疗治疗,观察组另给予益气解毒汤治疗。比较两组中医证候评分、胃肠功能恢复情况、胃肠激素水平[胃动素(MOT)、胃泌素(GAS)、胃饥饿素(Ghrelin)]、肿瘤标志物[癌胚抗原(CEA)、组织多肽特异性抗原(TPS)及糖类抗原199(CA199)]、营养指标[白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TRF)]、外周血Th1、Th2及Th1/Th2变化。对比两组治疗期间不良反应。结果:观察组治疗后主症、次症评分及总分均低于对照组(P<0.05)。观察组术后恢复时间(首次排气、排便时间及肠鸣音恢复时间)均短于对照组(P<0.05)。观察组治疗后MOT、GAS及Ghrelin水平均高于对照组(P<0.05)。观察组治疗后CEA、TPS及CA199水平均低于对照组(P<0.05)。观察组治疗后ALB、PA及TRF水平均高于对照组(P<0.05)。观察组治疗后Th1、Th1/Th2高于对照组(P<0.05),Th2低于对照组(P<0.05)。两组治疗期间不良反应发生率对比,差异无统计学意义(P>0.05)。结论:益气解毒汤治疗胃癌术后气虚血瘀证患者可改善临床症状,缩短胃肠功能恢复时间,促进胃肠激素分泌,降低肿瘤标志物水平,改善营养状况和Th1/Th2失衡状态,且安全可靠。Objective:To observe the effect of decoction of replenishing qi and detoxification on gastrointestinal function recovery and balance of helper T cell 1(Th1)/helper T cell 2(Th2)in patients with qi-deficiency and blood-stasis syndrome after gastric cancer surgery.Methods:78 postoperative gastric cancer patients with qi-deficiency and blood-stasis syndrome were divided into control group and observation group with 39 cases in each group.The control group was treated with enteral nutrition support and conventional chemotherapy,and the observation group was treated the same in addition to the decoction of replenishing qi and detoxification.The traditional Chinese medicine(TCM)syndrome score,gastrointestinal function recovery,gastrointestinal hormone level[motilin(MOT),gastrin(GAS),Ghrelin],tumor markers[carcinoembryonic antigen(CEA),tissue polypeptide specific antigen(TPS)and carbohydrate antigen 199(CA199)],nutritional index[albumin(ALB),prealbumin(PA),transferrin(TRF)],peripheral blood Th1,Th2 and Th1/Th2 changes were compared between the two groups.The adverse reactions during treatment were observed in the two groups.Results:After treatment,the scores of main symptoms,secondary symptoms and total scores in the observation group were lower than those in the control group(P<0.05).The postoperative recovery time(first exhaust,defecation,and bowel sound recovery time)of the observation group was shorter than that of the control group(P<0.05).The levels of MOT,GAS and Ghrelin in the observation group were higher than those in the control group(P<0.05).The levels of ALB,PA and TRF in the observation group were higher than those in the control group(P<0.05).Th1 and Th1/Th2 in the observation group were higher than those in the control group(P<0.05),while Th2 was lower than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during the treatment(P>0.05).Conclusion:Decoction of replenishing qi and detoxification can improve the clinical symptom

关 键 词：胃癌 中医药 益气解毒汤 不良反应 

分 类 号：R273.52[医药卫生—中西医结合]