中药辅助肠外营养对胃癌患者术后机体营养状态的影响

doi:10.3760/cma.j.issn.1007-1245.2023.04.012

国际医药卫生导报 ›› 2023, Vol. 29 ›› Issue (4): 492-496.DOI: 10.3760/cma.j.issn.1007-1245.2023.04.012

中药辅助肠外营养对胃癌患者术后机体营养状态的影响

陈晶晶王栓铎

南阳医学高等专科学校第一附属医院普通外科六病区，南阳　473000

收稿日期:2022-10-17 出版日期:2023-03-15 发布日期:2023-03-06
通讯作者: 陈晶晶，Email：chenjingjinin@163.com
基金资助:
河南省医学科技攻关项目（202100231）

Effect of parenteral nutrition assisted by traditional Chinese medicine on postoperative nutritional status in patients with gastric cancer

Chen Jingjing, Wang Shuanduo

Sixth Ward, Department of General Surgery, The First Affiliated Hospital of Nanyang Medical College, Nanyang 473000, China

Received:2022-10-17 Online:2023-03-15 Published:2023-03-06
Contact: Chen Jingjing, Email: chenjingjinin@163.com
Supported by:
Problem-tackling Project of Medical Science and Technology in Henan (202100231)

摘要/Abstract

摘要：

目的　观察在胃癌患者根治术后肠外营养（PN）支持治疗中联合应用中药黄芪注射液对改善机体营养状态的影响。方法　选取南阳医学高等专科学校第一附属医院2020年8月至2022年1月收治的84例胃癌患者进行随机对照试验。采用随机数字表法将患者分为观察组和对照组，各42例。观察组男22例，女20例，年龄（55.16±0.25）岁。对照组男23例，女19例，年龄（55.13±0.31）岁。两组术后均予以PN治疗，观察组在其基础上，采用黄芪注射液配合治疗。对比两组患者治疗7、15、30 d后体质量指数（BMI）、预后营养指数（PNI），治疗前后白蛋白（ALB）、转铁蛋白（TFN）、纤维连接蛋白（FN）等营养指标，以及治疗后生活质量、不良反应发生情况。采用t检验和χ²检验。结果　治疗7、15、30 d后，观察组BMI均高于对照组［（21.47±0.25）kg/m²比（20.54±0.35）kg/m²、（23.24±0.31）kg/m²比（21.06±0.45）kg/m²、（23.79±0.39）kg/m²比（22.13±0.36）kg/m²，t=14.013、25.855、20.269，均P<0.001］。治疗7、15、30 d后，观察组PNI均低于对照组［（42.14±0.36）%比（45.33±0.27）%、（38.45±0.37）%比（41.44±0.25）%、（32.11±0.46）%比（36.42±0.37）%，t=45.941、43.394、47.315，均P<0.001］。治疗后，观察组ALB、TFN、FN均高于对照组［（45.11±0.87）g/L比（42.72±0.33）g/L、（3.75±0.77）g/L比（2.64±0.17）g/L、（3.36±0.32）g/L比（2.14±0.41）g/L，t=16.646、9.123、15.202，均P<0.001］。治疗后，观察组生活质量综合评定问卷（GQOLI-74）躯体功能、心理功能、社会功能、物质生活状态、总体生活质量因子评分均高于对照组［（86.24±0.31）分比（84.14±0.25）分、（86.65±0.44）分比（84.33±0.27）分、（87.68±0.48）分比（85.16±0.36）分、（85.36±0.41）分比（83.14±0.28）分、（15.33±0.24）分比（13.24±0.16）分，t=34.174、29.125、27.219、28.978、46.958，均P<0.001］；观察组不良反应发生率略高于对照组［9.52%（4/42）比7.14%（3/42），χ²=0.371，P=0.543］。结论　在予以胃癌患者术后PN治疗的同时，加用黄芪注射液可显著改善机体营养状态，对提升患者生活质量具有积极意义，且加用此药未增加患者不良反应发生风险，安全性较高。

关键词:

胃癌根治术, 营养状态, 黄芪注射液, 肠外营养, 生活质量, 不良反应

Abstract:

Objective　To observe the effect of astragalus injection combined with parenteral nutrition (PN) on nutritional status in patients with gastric cancer after radical operation. Methods　Eighty-four patients with gastric cancer admitted to The First Affiliated Hospital of Nanyang Medical College from August 2020 to January 2022 were selected for the random control trial. The patients were divided into an observation group and a control group by the random number table method, with 42 cases in each group. There were 22 males and 20 females in the observation group; they were (55.16±0.25) years old. There 23 males and 19 females in the control group; they were (55.13±0.31) years old. Both groups took PN after the surgery; in addition, the observation group took astragalus injection. The body mass indexes (BMI), prognosis nutritional indexes (PNI) 7, 15, and 30 d after the treatment, the levels of albumin (ALB), transferrin (TFN), fibronectin (FN), and other nutritional indicators before and after the treatment, and the quality of life and adverse reactions after treatment were compared between the two groups. t and χ² tests were applied. Results　Seven, 15, and 30 d after the treatment, the BMI's in the observation group were higher than those in the control group [(21.47±0.25) kg/m² vs. (20.54±0.35) kg/m², (23.24±0.31) kg/m² vs. (21.06±0.45) kg/m², and (23.79±0.39) kg/m² vs. (22.13±0.36) kg/m²; t=14.013, 25.855, and 20.269; all P<0.001]. Seven, 15, and 30 d after the treatment, the PNI's in the observation group were lower than those in the control group [(42.14±0.36)% vs. (45.33±0.27)%, (38.45±0.37)% vs. (41.44±0.25)%,and (32.11±0.46)% vs. (36.42±0.37)%; t=45.941, 43.394, and 47.315; all P<0.001]. After the treatment, the levels of ALB, TFN, and FN in the observation group were higher than those in the control group [(45.11±0.87) g/L vs. (42.72±0.33) g/L, (3.75±0.77) g/L vs. (2.64±0.17) g/L, and (3.36±0.32) g/L vs. (2.14±0.41) g/L; t=16.646, 9.123, and 15.202; all P<0.001]. The scores of physical function, psychological function, social function, material life status, and overall quality of life factor of Generic Quality of Life Inventory-74 (GQOLI-74) in the observation group were higher than those in the control group [(86.24±0.31) vs. (84.14±0.25), (86.65±0.44) vs. (84.33±0.27), (87.68±0.48) vs. (85.16±0.36), (85.36±0.41) vs. (83.14±0.28), and (15.33±0.24) vs. (13.24±0.16); t=34.174, 29.125, 27.219, 28.978, and 46.958; all P<0.001]. The incidence of adverse reactions in the observation group was slightly higher than that in the control group [9.52% (4/42) vs. 7.14% (3/42); χ²=0.371, P=0.543]. Conclusion　PN combined with astragalus injection for gastric cancer patients after surgery can significantly improve their nutritional status and quality of life and does not increase the risk of adverse reactions with high safety.

Key words:

Radical gastrectomy, Nutritional status, Astragalus injection, Parenteral nutrition, Quality of life, Adverse reactions

陈晶晶王栓铎.

中药辅助肠外营养对胃癌患者术后机体营养状态的影响 [J]. 国际医药卫生导报, 2023, 29(4): 492-496.

Chen Jingjing, Wang Shuanduo.

Effect of parenteral nutrition assisted by traditional Chinese medicine on postoperative nutritional status in patients with gastric cancer [J]. International Medicine and Health Guidance News, 2023, 29(4): 492-496.

参考文献

[1] 曹毛毛,李贺,孙殿钦,等. 2000—2019年中国胃癌流行病学趋势分析[J]. 中华消化外科杂志,2021,20(1):102-109. DOI:10.3760/cma.j.cn115610-20201130-00746.
[2] 郑果果.全腹腔镜与腹腔镜辅助胃癌根治术治疗局部进展期远端胃癌的效果比较[J].临床医学研究与实践,2022,7(23): 46-48. DOI: 10.19347/j.cnki.2096-1413. 202223013.
[3] Health Commission Of The People's Republic Of China N. National guidelines for diagnosis and treatment of gastric cancer 2022 in China (English version) [J]. Chin J Cancer Res, 2022, 34(3):207-237. DOI: 10.21147/j.issn.1000-9604.2022.03.04.
[4] Takahashi T, Kaneoka Y, Maeda A, et al. The preoperative prognostic nutrition index is a prognostic indicator for survival in elderly gastric cancer patients after gastrectomy: a propensity score-matched analysis [J]. Updates Surg, 2020, 72(2):483-491. DOI: 10.1007/s13304-020-00745-2.
[5] 毛世臣.谷氨酰胺与精氨酸联用肠内、肠外营养支持治疗对进展期胃癌患者术后康复的研究进展[J].抗感染药学,2022,19(1):10-12. DOI:10.13493/j.issn.1672-7878. 2022.01-003.
[6] 李颖颖.基于营养风险筛查的标准营养支持治疗对胃癌术后患者恢复情况的影响[J].实用中西医结合临床,2021,21(20):90-91, 95. DOI:10.13638/j.issn.1671-4040. 2021.20.043.
[7] 钱晶,王小红,魏本忠,等.谷参肠安辅助肠内营养支持治疗老年胃癌术后患者临床研究[J].辽宁中医药大学学报,2021,23(6):12-16. DOI:10.13194/j.issn.1673- 842x. 2021.06.004.
[8] 胡竹元,吕智燚,傅健飞,徐斌.黄芪桂枝五物汤对进展期胃癌化疗患者免疫功能、不良反应的影响[J].中华中医药学刊,2022,40(4):92-95. DOI: 10.13193/j.issn.1673-7717. 2022.04.019.
[9] 杨晓晴. 黄芪建中汤联合新辅助化疗对进展期胃癌患者的疗效及肿瘤标志物水平影响[J]. 中国中医药现代远程教育,2022,20(6):91-93. DOI: 10.3969/j.issn.1672-2779. 2022.06.034.
[10] 所剑,李伟.第5版日本«胃癌治疗指南»解读[J].中国实用外科杂志,2018,38(4):407-413. DOI: 10.19538/j.cjps.issn1005-2208.2018.04.16.
[11] Wang H, Xu YY, You J, et al. Onodera's Prognostic Nutritional Index is a novel and useful prognostic marker for gastrointestinal stromal tumors [J]. World J Gastrointest Surg, 2021,13(10):1202-1215. DOI: 10.4240/wjgs.v13.i10.1202.
[12] 张明凯,穆东,陈艳,等.腹腔镜D2根治术联合胃背侧系膜近胃端完整系膜切除术治疗进展期胃癌的近期疗效[J].中国现代医学杂志,2021,31(14):30-34. DOI:10.3969/j.issn.1005-8982.2021.14.006.
[13] 王留庆.分析早期肠内营养支持治疗对胃癌患者术后康复的影响[J].中国继续医学教育,2018,10(24):66-67. DOI: 10.3969/j.issn.1674-9308.2018.24.034.
[14] 袁颐捷,吴华.临床药师参与胃癌化疗后中性粒细胞缺乏患者营养支持治疗的药学监护实践[J].临床合理用药杂志,2018,11(27):113-114.
[15] 白璃. 胃癌患者远端胃大部切除联合Roux-en-Y吻合术后营养支持治疗的临床研究[J]. 中国实用医刊,2019,46(9):79-82. DOI:10.3760/cma.j.issn.1674-4756.2019.09.024.
[16] 单廷,陈义钢,洪波,等. ω-3鱼油脂肪乳在胃癌根治术后肠外营养支持治疗中的应用价值[J]. 中华消化外科杂志,2019,18(10):960-965. DOI:10.3760/cma.j.issn. 1673-9752. 2019.10.012.
[17] 傅金龙,汪勇,胡可,等.黄芪对腹腔镜下胃大部切除术后胃癌患者T细胞亚群的影响[J].中华中医药学刊,2017,35(10):2654-2656. DOI: 10.13193/j.issn.1673-7717. 2017.10.048.
[18] 王道军,王晨,伍权,等.黄芪注射液对胃癌大鼠血清炎症机制、p53、STAT3、VEGF表达的影响[J].中国老年学杂志,2016,36(18):4405-4407. DOI: 10.3969/j.issn.1005-9202. 2016.18.001.
[19] 张文山,左东明,何淑兵,等. 黄芪注射液联合丹参注射液治疗进展期胃癌临床研究[J]. 河北中医,2020,42(8):1175-1178,1182. DOI:10.3969/j.issn.1002-2619. 2020.08.012.
[20] 贾淑云,乔趁心,吴晓雷.黄芪注射液配合肠外营养支持用于胃癌患者术后康复的临床研究[J].中国临床药理学杂志,2022,38(2):99-102. DOI:10.13699/j.cnki.1001-6821. 2022.02.001.

中药辅助肠外营养对胃癌患者术后机体营养状态的影响

Effect of parenteral nutrition assisted by traditional Chinese medicine on postoperative nutritional status in patients with gastric cancer

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 2

编辑推荐

Metrics

[1]	郭闪闪李志鹏张颖. 针刺联合经颅磁刺激对脑梗死合并帕金森综合征患者的疗效 [J]. 国际医药卫生导报, 2023, 29(5): 642-646.
[2]	罗青林熊蕾蕾. 支气管镜肺泡灌洗联合甲泼尼龙对难治性肺炎支原体肺炎患儿的影响 [J]. 国际医药卫生导报, 2023, 29(1): 49-.