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[黄芪与绞股蓝药对结直肠癌术后患者肠道屏障的影响]

[Effects of Couplet Medicines (Astragalus Membranaceus and Jiaozhen) on Intestinal Barrier in Postoperative Colorectal Cancer Patients].

作者信息

Wang Qian-zhu, Chen Xiao-ping, Huang Jian-ping, Jiang Xu-wei

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2015 Nov;35(11):1307-12.

Abstract

OBJECTIVE

To observe the effect of the couplet medicines (Astragalus Membranaceus and Jiaozhen) on intestinal barrier functions of postoperative colorectal cancer patients.

METHODS

Totally 90 inpatients with confirmed colorectal cancer by pathological diagnosis were recruited as subjects in this study. They were assigned to the Chinese medicine group (CM, treated with Astragalus Membranaceus and Jiaozhen), the Western medicine group (WM, treated with glutamine), and the blank control group (treated with normal saline) according to random digit table, 30 in each group. The treatment course consisted of eight days. Levels of blood D-lactic acid, diamine oxidase (DAO), urinary lactulose/mannitol ratio (L/M), ET, TNF-alpha, and postoperative recovery time of bowel sound were observed before surgery and after surgery. The effect of the couplet medicines (Astragalus Membranaceus and Jiaozhen) on intestinal barrier functions of postoperative colorectal cancer patients were comprehensively assessed by taking blood D-lactic acid levels, DAO levels, urinary L/M as main potency indices; ET and TNF-alpha, recovery time of bowel sound as the secondary potency indices.

RESULTS

CM showed similar effect with that of WM in improving blood D-lactic acid levels and DAO levels, and urinary L/M ratio, with no statistical difference between them (P > 0.05). But they showed better effect than that of the blank control group (P < 0.05). Levels of ET and TNF-alpha were decreased more in the CM group than in the WM group (P < 0.05). The recovery time of bowel sound was shorter in the CM group than in the WM group (P < 0.05, P < 0.01). Levels of ET and TNF-alpha were decreased more in the WM group than in the blank control group (P < 0.05). There was no statistical difference in the recovery time of bowel sound between the WM group and the blank control group (P > 0.05).

CONCLUSIONS

The couplet medicines (Astragalus Membranaceus and Jiaozhen) had obvious protection for intestinal barrier dysfunction of postoperative colorectal cancer patients, showing similar efficacy to that of WM. It was even superior to glutamine in restoring bowel functions, reducing toxin absorption, and lowering levels of pro-inflammatory factors.

摘要

目的

观察黄芪和绞股蓝联用药物对结直肠癌术后患者肠道屏障功能的影响。

方法

选取90例经病理诊断确诊为结直肠癌的住院患者作为研究对象。根据随机数字表将他们分为中药组(CM,采用黄芪和绞股蓝治疗)、西药组(WM,采用谷氨酰胺治疗)和空白对照组(采用生理盐水治疗),每组30例。疗程为8天。观察手术前后血液中D - 乳酸、二胺氧化酶(DAO)、尿乳果糖/甘露醇比值(L/M)、内皮素(ET)、肿瘤坏死因子 -α(TNF -α)水平以及肠鸣音术后恢复时间。以血液D - 乳酸水平、DAO水平、尿L/M作为主要效能指标;ET和TNF -α、肠鸣音恢复时间作为次要效能指标,综合评估黄芪和绞股蓝联用药物对结直肠癌术后患者肠道屏障功能的影响。

结果

中药组在改善血液D - 乳酸水平、DAO水平及尿L/M比值方面与西药组效果相似,两组间差异无统计学意义(P > 0.05)。但二者均优于空白对照组(P < 0.05)。中药组ET和TNF -α水平下降幅度大于西药组(P < 0.05)。中药组肠鸣音恢复时间短于西药组(P < 0.05,P < 0.01)。西药组ET和TNF -α水平下降幅度大于空白对照组(P < 0.05)。西药组与空白对照组肠鸣音恢复时间差异无统计学意义(P > 0.05)。

结论

黄芪和绞股蓝联用药物对结直肠癌术后患者肠道屏障功能障碍有明显保护作用,疗效与西药相似。在恢复肠道功能、减少毒素吸收及降低促炎因子水平方面甚至优于谷氨酰胺。

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