宣白承气汤对湿热蕴结型结直肠癌术后患者康复效果的影响  

Effects of Xuanbai Chengqi Decoction on rehabilitation of patients with colorectal cancer of damp-heat pattern after surgery

作　　者：于淼[1] 路夷平[1] 陈谦 张洪海[1] 梁燕凯 冀祯 YU Miao;LU Yiping;CHEN Qian;ZHANG Honghai;LIANG Yankai;JI Zhen(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《湖南中医药大学学报》2025年第3期523-528,共6页Journal of Hunan University of Chinese Medicine

基　　金：北京市属医院科研培育计划项目(PZ2022008)。

摘　　要：目的探讨宣白承气汤对湿热蕴结型结直肠癌术后患者康复效果的影响。方法将2021年12月至2023年12月在首都医科大学附属北京中医医院的100例湿热蕴结型结直肠癌术后患者采用随机数字表法分为2组,每组50例。对照组在围手术期接受标准治疗,观察组在对照组基础上术前口服宣白承气汤,疗程为7 d。比较2组患者术后胃肠功能恢复情况、中医证候积分、免疫因子[粒细胞-巨噬细胞集落刺激因子(GM-CSF)、核苷酸结合寡聚化结构域样受体3(NLRP3)、Toll样受体4(TLR4)水平]、肺功能[第1秒最大呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC]及欧洲癌症研究与治疗组织生命质量量表(EORCT QLQ-C30)评分、中医证候疗效及并发症发生情况。结果治疗后,观察组术后胃肠功能恢复用时均短于对照组(P<0.01)。与术前比较,2组患者术后的中医证候各项积分及总分、血清NLRP3水平、TLR4水平均降低(P<0.05),EORCT QLQ-C30各维度评分、GM-CSF水平、FEV_(1)、FVC、FEV_(1)/FVC均升高(P<0.05);且观察组中医证候积分、血清NLRP3水平、TLR4水平低于对照组(P<0.05),EORCT QLQ-C30各维度评分、GM-CSF水平、FEV_(1)、FVC、FEV_(1)/FVC高于对照组(P<0.05)。观察组总有效率为96.00%,高于对照组的84.00%(P<0.05)。观察组并发症发生率为4.00%,低于对照组的16.00%(P<0.05)。结论术前应用宣白承气汤能有效改善结直肠癌患者术后临床症状,在促进胃肠功能恢复、改善免疫功能和肺功能方面效果显著,可有效降低术后并发症发生风险,提高患者生活质量。Objective To investigate the effects of Xuanbai Chengqi Decoction(XBCQD)on rehabilitation of patients with colorectal cancer of damp-heat pattern after surgery.Methods A total of 100 postoperative patients with colorectal cancer of damp-heat pattern from December 2021 to December 2023 at Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University were divided into two groups by random number table method,with 50 cases in each group.The control group received standard treatment during the perioperative period,while the observation group received oral XBCQD preoperatively for a course of seven days in addition to the standard treatment provided to the control group.The postoperative gastrointestinal function recovery,Chinese medicine(CM)pattern scores and levels of immune factors[granulocyte-macrophage colony-stimulating factor(GM-CSF),nucleotide-binding oligomerization domain-like receptor 3(NLRP3),and toll-like receptor 4(TLR4)],lung function[forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),and FEV_(1)/FVC],scores on European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30(EORTC QLQ-C30),efficacy in CM pattern,and incidence of complications were compared between two groups of patients.Results After treatment,the observation group had a shorter recovery time for postoperative gastrointestinal function compared to the control group(P<0.01).Compared with before the surgery,in both groups,the scores of each item and the total score of CM pattern,as well as the serum levels of NLRP3 and TLR4 at seven days after the surgery decreased(P<0.05),while the scores of each dimension of the EORTC QLQ-C30,the levels of GM-CSF,FEV_(1),FVC,and FEV_(1)/FVC increased(P<0.05).Moreover,the CM pattern scores,the serum levels of NLRP3 and TLR4 in the observation group were lower than those in the control group(P<0.05),while the scores of each dimension of the EORTC QLQ-C30,the levels of GM-CSF,FEV_(1),FVC,and FEV_(1)/FVC were higher than tho

关 键 词：结直肠癌 宣白承气汤 胃肠功能 肺功能 免疫功能 临床疗效 

分 类 号：R273[医药卫生—中西医结合]