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芪黄汤联合肠内营养对胃癌术后营养及免疫功能的影响

Effect of Qihuang Decoction Combined with Enteral Nutrition on Postoperative Gastric Cancer of Nutrition and Immune Function.

作者信息

Yu Qing-Sheng, Zheng Zhou, Peng Hui, Shen Yi, Liu Ju-da, Zhou Fu-Hai

机构信息

Department of General Surgery, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China.

Institute of Chinese Medicine Surgery, Anhui University of Traditional Chinese Medicine, Hefei, China.

出版信息

Evid Based Complement Alternat Med. 2020 Feb 29;2020:1795107. doi: 10.1155/2020/1795107. eCollection 2020.

DOI:10.1155/2020/1795107
PMID:32215032
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7079248/
Abstract

OBJECTIVE

Early nutritional support in patients with gastric cancer can improve their nutritional status, but the impact on immune function has not been confirmed. This study aimed to analyze the effects of Qihuang decoction combined with enteral nutrition on nutrition and the immune function of postoperative gastric cancer.

METHODS

120 patients with postoperative gastric cancer in the study group and 117 in the control group were selected as the study subjects from our hospital at random. Indications of nutrition and immune and the rates of complications were compared the day before surgery and 1, 3, 7, and 14 days after surgery.

RESULTS

Indications of nutrition except hemoglobin (HB) in the study group were significantly higher than those before operation and the albumin (ALB) and prealbumin (TP) were significantly increased 7 and 14 days after surgery ( < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 and < 0.001 versus < 0.001 and < 0.001) and the protein (PA) 3, 7, and 14 days after surgery (=0.011, =0.002, and =0.022) in the study group compared to those in the control group. Cellular and humoral immunity indications in the study group are significantly higher than those before operation compared to those in the control group, and the CD3, CD4, and CD4/CD8 were significantly increased 7 and 14 days after surgery (=0.027 and < 0.001 versus =0.008 and < 0.001 versus =0.010 and < 0.001) and IgA, IgG, and IgM 3, 7, and 14 days after surgery in the study group ( < 0.001, < 0.001, and < 0.001 versus < 0.001, < 0.002, and < 0.001 versus < 0.001, < 0.001, and < 0.001). The complications such as abdominal, lung, wound, and urinary infection were also significantly decreased ( =0.017; < 0.001 and < 0.001 versus < 0.001 and < 0.001) and the protein (PA) 3, 7, and 14 days after surgery (=0.011, =0.002, and =0.022) in the study group compared to those in the control group. Cellular and humoral immunity indications in the study group are significantly higher than those before operation compared to those in the control group, and the CD3, CD4, and CD4/CD8 were significantly increased 7 and 14 days after surgery (=0.027 and < 0.001 versus =0.008 and < 0.001 versus =0.010 and < 0.001) and IgA, IgG, and IgM 3, 7, and 14 days after surgery in the study group ( < 0.001, < 0.001, and < 0.001 versus < 0.001, < 0.002, and < 0.001 versus < 0.001, < 0.001, and < 0.001). The complications such as abdominal, lung, wound, and urinary infection were also significantly decreased ( =0.017; < 0.001 and < 0.001 versus < 0.001 and < 0.001) and the protein (PA) 3, 7, and 14 days after surgery (=0.011, =0.002, and =0.022) in the study group compared to those in the control group. Cellular and humoral immunity indications in the study group are significantly higher than those before operation compared to those in the control group, and the CD3, CD4, and CD4/CD8 were significantly increased 7 and 14 days after surgery (=0.027 and < 0.001 versus =0.008 and < 0.001 versus =0.010 and < 0.001) and IgA, IgG, and IgM 3, 7, and 14 days after surgery in the study group ( < 0.001, < 0.001, and < 0.001 versus < 0.001, < 0.002, and < 0.001 versus < 0.001, < 0.001, and < 0.001). The complications such as abdominal, lung, wound, and urinary infection were also significantly decreased ( =0.017; < 0.001 and < 0.001 versus < 0.001 and < 0.001) and the protein (PA) 3, 7, and 14 days after surgery (=0.011, =0.002, and =0.022) in the study group compared to those in the control group. Cellular and humoral immunity indications in the study group are significantly higher than those before operation compared to those in the control group, and the CD3, CD4, and CD4/CD8 were significantly increased 7 and 14 days after surgery (=0.027 and < 0.001 versus =0.008 and < 0.001 versus =0.010 and < 0.001) and IgA, IgG, and IgM 3, 7, and 14 days after surgery in the study group ( < 0.001, < 0.001, and < 0.001 versus < 0.001, < 0.002, and < 0.001 versus < 0.001, < 0.001, and < 0.001). The complications such as abdominal, lung, wound, and urinary infection were also significantly decreased ( =0.017; =0.036; =0.041; =0.004).

CONCLUSIONS

Qihuang decoction combined with enteral nutrition can promote the absorption of enteral nutrition with improving the immune and reducing complications of infection.

摘要

目的

胃癌患者早期营养支持可改善其营养状况，但对免疫功能的影响尚未得到证实。本研究旨在分析芪黄汤联合肠内营养对胃癌术后营养及免疫功能的影响。

方法

从我院随机选取研究组120例胃癌术后患者和对照组117例患者作为研究对象。比较手术前及术后1、3、7和14天的营养、免疫指标及并发症发生率。

结果

研究组除血红蛋白（HB）外的营养指标均显著高于术前，术后7天和14天白蛋白（ALB）和前白蛋白（TP）显著升高（<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且<0.001且

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26ed/7079248/271a296ba98a/ECAM2020-1795107.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26ed/7079248/271a296ba98a/ECAM2020-1795107.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26ed/7079248/271a296ba98a/ECAM2020-1795107.001.jpg

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Front Microbiol. 2021 Dec 9;12:739348. doi: 10.3389/fmicb.2021.739348. eCollection 2021.
Effect of Enteral Immunonutrition on Immune, Inflammatory Markers and Nutritional Status in Gastric Cancer Patients Undergoing Gastrectomy: A Randomized Double-Blinded Controlled Trial.
肠内免疫营养对胃癌患者胃切除术后免疫、炎症标志物和营养状况的影响：一项随机双盲对照试验。
J Invest Surg. 2020 Dec;33(10):950-959. doi: 10.1080/08941939.2019.1569736. Epub 2019 Mar 19.
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[Effect of Qihuang Decoction on the Intestinal Mucosal Immunologic Barrier of Rats after Gastric Resection].芪黄汤对胃切除术后大鼠肠道黏膜免疫屏障的影响
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016 Nov;36(11):1358-1363.
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Apoptosis of human gastric carcinoma MGC-803 cells induced by a novel Astragalus membranaceus polysaccharide via intrinsic mitochondrial pathways.新型黄芪多糖通过内在线粒体途径诱导人胃癌 MGC-803 细胞凋亡。
Int J Biol Macromol. 2019 Apr 1;126:811-819. doi: 10.1016/j.ijbiomac.2018.12.268. Epub 2018 Dec 31.
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Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.全球癌症统计数据 2018：GLOBOCAN 对全球 185 个国家/地区 36 种癌症的发病率和死亡率的估计。
CA Cancer J Clin. 2018 Nov;68(6):394-424. doi: 10.3322/caac.21492. Epub 2018 Sep 12.
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Qihuang decoction promotes the recovery of intestinal immune barrier dysfunction after gastrectomy in rats.芪黄汤促进大鼠胃癌切除术后肠道免疫屏障功能障碍的恢复。
Am J Transl Res. 2018 Mar 15;10(3):827-836. eCollection 2018.
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Enteral immunonutrition versus enteral nutrition for gastric cancer patients undergoing a total gastrectomy: a systematic review and meta-analysis.全胃切除术后胃癌患者的肠内免疫营养与肠内营养：系统评价与荟萃分析
BMC Gastroenterol. 2018 Jan 16;18(1):11. doi: 10.1186/s12876-018-0741-y.
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Rhubarb Supplementation Promotes Intestinal Mucosal Innate Immune Homeostasis through Modulating Intestinal Epithelial Microbiota in Goat Kids.补充大黄通过调节山羊幼崽肠道上皮微生物群促进肠道黏膜固有免疫稳态
J Agric Food Chem. 2018 Jan 31;66(4):1047-1057. doi: 10.1021/acs.jafc.7b05297. Epub 2018 Jan 23.
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Incidence and Risk Factors for Anastomotic Failure in 1594 Patients Treated by Transanal Total Mesorectal Excision: Results From the International TaTME Registry.经肛全直肠系膜切除术治疗的 1594 例患者吻合口失败的发生率和危险因素：国际 TaTME 注册研究结果。
Ann Surg. 2019 Apr;269(4):700-711. doi: 10.1097/SLA.0000000000002653.