Cai Jun, Wang Hua, Zhou Sheng, Wu Bin, Song Hua-Rong, Xuan Zheng-Rong
Department of General Surgery, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
Zhong Xi Yi Jie He Xue Bao. 2008 Jan;6(1):37-40. doi: 10.3736/jcim20080108.
To observe the effect of perioperative application of Sijunzi Decoction and enteral nutrition on T-cell subsets and nutritional status in patients with gastric cancer after operation.
In this prospective, single-blinded, controlled clinical trial, fifty-nine patients with gastric cancer were randomly divided into three groups: control group (n=20) and two study groups (group A, n=21; group B, n=18). Sjunzi Decoction (100 ml) was administered via nasogastric tube to the patients in the study group B from the second postoperation day to the 9th postoperation day. Patients in the two study groups were given an isocaloric and isonitrogonous enteral diet, which was started on the second day after operation, and continued for eight days. Patients in the control group were given an isocaloric and isonitrogonous parenteral diet for 9 days. All variables of nutritional status such as serum albumin (ALB), prealbumin (PA), transferrin (TRF) and T-cell subsets were measured one day before operation, and one day and 10 days after operation.
All the nutritional variables and the levels of CD3(+), CD4(+), CD4(+)/CD8(+) were decreased significantly after operation. Ten days after operation, T-cell subsets and nutritional variables in the two study groups were increased as compare with the control group. The levels of ALB, TRF and T-cell subsets in the study group B were increased significantly as compared with the study group A (P<0.05).
Enteral nutrition assisted with Sijunzi Decoction can positively improve and optimize cellular immune function and nutritional status in the patients with gastric cancer after operation.
观察四君子汤围手术期应用联合肠内营养对胃癌患者术后T细胞亚群及营养状况的影响。
在这项前瞻性、单盲、对照临床试验中，59例胃癌患者被随机分为三组：对照组（n = 20）和两个研究组（A组，n = 21；B组，n = 18）。研究组B的患者从术后第二天至术后第九天经鼻胃管给予四君子汤（100 ml）。两个研究组的患者均给予等热量、等氮量的肠内饮食，术后第二天开始，持续八天。对照组患者给予等热量、等氮量的肠外饮食9天。在术前一天、术后一天和术后10天测量所有营养状况变量，如血清白蛋白（ALB）、前白蛋白（PA）、转铁蛋白（TRF）和T细胞亚群。
术后所有营养变量以及CD3(+)、CD4(+)、CD4(+)/CD8(+)水平均显著下降。术后10天，两个研究组的T细胞亚群和营养变量与对照组相比有所增加。研究组B的ALB、TRF水平和T细胞亚群与研究组A相比显著升高（P<0.05）。
四君子汤辅助肠内营养可积极改善和优化胃癌患者术后的细胞免疫功能和营养状况。
