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目的:观察鼻饲健脾益气中药联合早期肠内营养对胃癌患者术后营养状况和免疫功能的影响。方法:采用随机数字表法将符合筛选要求的60例胃癌手术患者随机分成治疗组和对照组,每组30例。两组患者均术后第2天开始通过鼻肠营养管给予瑞能肠内营养支持,治疗组患者在此基础上给予四君子汤加减治疗,连续治疗至术后第7天。所有患者均于术前、术后第8天测量体质量、术前和术后第1、第8天上臂围(AMC)、三头肌皮褶厚度(TSF)、血红蛋白(Hb)、白蛋白(Alb)、前白蛋白(PA)、免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)、免疫球蛋白A(Ig A)、CD3~+、CD4~+、CD4~+/CD8~+比值等。结果:两组患者除AMC、TSF手术前后差异无统计学意义(P>0.05)外,其余各项营养及免疫项指标术后第1天均较术前降低,差异均有统计学意义(P<0.05),但组间比较,各指标差异无统计学意义(P>0.05);术后第8天,治疗组患者各项免疫及营养指标改善均优于对照组,差异均有统计学意义(P<0.05)。结论:健脾益气中药联合早期肠内营养能改善胃癌患者术后营养状况和免疫功能,从而促进患者早日康复。
Objective: To observe the effects of nasal feeding, invigorating the spleen and invigorating Qi and traditional Chinese medicine in combination with early enteral nutrition on nutritional status and immune function of gastric cancer patients. Methods: A total of 60 gastric cancer patients who met the screening criteria were randomly divided into treatment group and control group with 30 cases in each group. Enteral nutrition support was given to the patients in both groups on the second day after surgery, and the patients in the treatment group were treated with Si Jun Zi Decoction on the basis of the above treatment. The patients were continuously treated until the 7th day after operation. All patients were measured preoperatively and postoperatively on the 8th day. Body weight, AMC, TSF, Hb, albumin (Alb), prealbumin (PA), immunoglobulin G (Ig G), immunoglobulin M (Ig M), immunoglobulin A (Ig A), CD3 +, CD4 + CD8 ~ + ratio and so on. Results: Except for AMC and TSF, there was no significant difference between the two groups before and after surgery (P> 0.05), and the other indexes of nutrition and immunity were all lower than preoperative one day after operation (P <0.05), but there was no significant difference between the two groups (P> 0.05). On the 8th day after operation, all the immunological and nutritional indexes in the treatment group were better than those in the control group, the differences were statistically significant (P <0.05). Conclusion: The combined Chinese medicine of invigorating the spleen and strengthening qi and early enteral nutrition can improve the nutritional status and immune function of postoperative patients with gastric cancer, so as to promote the early recovery of the patients.