Wang Xiao-Dong, Su Xiao-Qing, Gao Hong
Department of Oncology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110032, Liaoning Province, China.
Department of Traditional Chinese Medicine, Tawan Community Health Service Center, Shenyang 110032, Liaoning Province, China.
World J Gastrointest Surg. 2025 Apr 27;17(4):100800. doi: 10.4240/wjgs.v17.i4.100800.
The deleterious effects of surgical trauma and subsequent postoperative complications pose significant challenges to the smooth recovery of patients after gastric cancer (GC) resection despite the substantial curative benefits provided by surgical interventions for GC. Hence, the investigation of more optimal and efficacious treatment approaches has become an urgent necessity in the medical community.
To investigate the association of Sijunzi decoction plus chemotherapy with the gastrointestinal function and serum markers of patients after GC surgery.
This study included patients who underwent GC surgery from June 2022 to February 2024. The control group included 45 patients who received chemotherapy (oxaliplatin + calcium folinate + 5-fluorouracil), whereas the research group consisted of 54 patients who received Sijunzi decoction therapy in addition to the treatment administered in the control group. Comparative analyses were conducted from the following perspectives: Gastrointestinal function (defecation time, intestinal gas discharge time, and hospitalization time), serum markers [carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 125, and CA199], nutritional indicators [total protein (TP) and transferrin (TRF), traditional Chinese medicine (TCM) syndrome score, and grades III-IV adverse events (gastrointestinal reactions, renal/liver function impairment, and myelosuppression).
The two groups demonstrated similar defecation time ( > 0.05), but the intestinal gas discharge time and hospitalization time were significantly shortened in the research group ( < 0.05). Further, the research group exhibited significant CEA, CA125, and CA199 reductions after treatment, which were lower compared to the control group, as well as notable increases in TP and TRF that were statistically higher than the control group (all < 0.05). Furthermore, the research group demonstrated an evident decrease in TCM syndrome scores in areas, such as poor appetite, epigastric distension and pain, fatigue and weakness ( < 0.01), and abdominal distension after eating, which are notably lower than those in the control group ( < 0.01), with a comparable incidence of grades III-IV adverse events ( > 0.05).
Our research results indicate that Sijunzi decoction plus chemotherapy exerts a good rehabilitation-promoting effect on gastrointestinal function in patients after GC surgery and significantly downregulates abnormally increased CEA, CA125, and CA199 levels.
手术创伤及术后并发症的有害影响给胃癌（GC）切除术后患者的顺利康复带来了重大挑战，尽管手术干预对GC具有显著的治疗益处。因此，探索更优化、有效的治疗方法已成为医学界的迫切需求。
探讨四君子汤联合化疗与GC术后患者胃肠功能及血清标志物的关系。
本研究纳入2022年6月至2024年2月接受GC手术的患者。对照组包括45例接受化疗（奥沙利铂+亚叶酸钙+5-氟尿嘧啶）的患者，而研究组由54例在对照组治疗基础上接受四君子汤治疗的患者组成。从以下几个方面进行比较分析：胃肠功能（排便时间、排气时间和住院时间）、血清标志物[癌胚抗原（CEA）、糖类抗原（CA）125和CA199]、营养指标[总蛋白（TP）和转铁蛋白（TRF）]、中医证候评分以及Ⅲ-Ⅳ级不良事件（胃肠道反应、肾/肝功能损害和骨髓抑制）。
两组排便时间相似（>0.05），但研究组排气时间和住院时间显著缩短（<0.05）。此外，研究组治疗后CEA、CA125和CA199显著降低，低于对照组，且TP和TRF显著升高，统计学上高于对照组（均<0.05）。此外，研究组在食欲减退、胃脘胀满疼痛、神疲乏力（<0.01）以及食后腹胀等方面的中医证候评分明显降低，显著低于对照组（<0.01），Ⅲ-Ⅳ级不良事件发生率相当（>0.05）。
我们的研究结果表明，四君子汤联合化疗对GC术后患者的胃肠功能具有良好的促康复作用，并能显著下调异常升高的CEA、CA125和CA199水平。
