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[大黄联合肠内营养对胃癌患者围手术期外周血C反应蛋白及白细胞介素-6的影响]

[Effect of rhubarb combined with enteral nutrition on C-reactive protein and interleukin-6 in peripheral blood of patients with gastric cancer during perioperative period].

作者信息

Wang Hua, Guo Li-jie, Wu Bin

机构信息

Department of General Surgery of Integrative Chinese and Western Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2008 Feb;28(2):101-4.

Abstract

OBJECTIVE

To observe the effects of rhubarb and enteral nutrition on C-reactive protein (CRP) and interleukin-6 (IL-6) in peripheral blood of patients with gastric cancer during perioperative period.

METHODS

Fifty-six patients with gastric cancer were randomly assigned to three groups. The 20 patients in Group A were given conventional fluid supplement and parenteral nutrition; the 21 patients in Group B were given conventional fluid supplement and enteral nutrition via nasal feeding starting from the 42nd hour to the 8th day after operation; and the 15 patients in Group C were treated, besides the same fluid supplement and enteral nutrition as that for Group B, with additional three times of 10% rhubarb liquid medication, given at the day before operation (100 mL), and the 18th and 42th hour post-operation (50 mL in each time). Serum levels of CRP and IL-6 of all patients were measured at different time points, i. e. the day before operation (T0), the 1st (T1), 3rd (T2) and 7th day (T3) after operation.

RESULTS

Acute inflammatory reaction happened in all the patients. However, the plasma level of CRP and IL-6 in Group C at T3 (12.67 +/- 4.28 mg/L and 18.17 +/- 11.10 mg/L) was significantly lower than those in Group A (19.72 +/- 9.73 mg/L and 20.44 +/- 6.32 mg/L) and Group B (21.27 +/- 10.46 mg/L and 20.29 +/- 7.79 mg/L), respectively (P < 0.05). And the recovery time of borborgmus in Group C were the shortest among the three groups.

CONCLUSION

Applying rhubarb on gastric cancer patients during perioperative period can effectively decrease the levels of CRP and IL-6 in peripheral blood, alleviate acute inflammatory reaction caused by operative trauma, promote the recovery of postoperative gastrointestinal motility and be beneficial for the supplement of enteral nutrition.

摘要

目的

观察大黄与肠内营养对胃癌患者围手术期外周血C反应蛋白(CRP)及白细胞介素-6(IL-6)的影响。

方法

56例胃癌患者随机分为三组。A组20例给予常规补液及肠外营养;B组21例在术后第42小时至第8天给予常规补液及经鼻饲管肠内营养;C组15例,除给予与B组相同的补液及肠内营养外,术前1天给予10%大黄液100 mL,术后第18小时和第42小时各给予50 mL,共用药3次。于术前1天(T0)、术后第1天(T1)、第3天(T2)和第7天(T3)等不同时间点检测所有患者血清CRP和IL-6水平。

结果

所有患者均发生急性炎症反应。但C组术后第7天(T3)时CRP血浆水平(12.67±4.28 mg/L)及IL-6血浆水平(18.17±11.10 mg/L)分别显著低于A组(19.72±9.73 mg/L和20.44±6.32 mg/L)及B组(21.27±10.46 mg/L和20.29±7.79 mg/L)(P<0.05)。且C组肠鸣音恢复时间为三组中最短。

结论

围手术期对胃癌患者应用大黄可有效降低外周血CRP及IL-6水平,减轻手术创伤所致的急性炎症反应,促进术后胃肠动力恢复,有利于肠内营养补充。

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