医药学论文：大黄对胃癌手术患者急性炎性反应的调理作用

【关键词】 胃肿瘤
［关键词］ 胃肿瘤; 大黄; 细胞因子; 肠道营养
ABSTRACT Objective:To observe the effect of perioperative administration of rhubarb on the acute inflammatory response in patients with gastric cancer. Methods: In this prospective, singleblinded, controlled clinical trial, thirtyone patients with gastric cancer operatively treated were randomly divided into two groups, with 14 patients in control group and 17 in study group. Patients in both groups were given an isocaloric and isonitrogenous enteral diet. The enteral diet was started 36 hours after operation, and continued for 6 days. Patients in the study group were fed with rhubarb before operation, and at 1 day and 2 days after operation. Indexes of acute inflammatory response such as serum Creactive protein (CRP), interleukin6 (IL6) and tumor necrosis factor α (TNFα), and indexes of nutritional status such as serum albumin (ALB), prealbumin (PA) and transferrin (TRF) were measured before operation, and at 1 day, 3 and 7 days after operation. Results: Patients in both groups had acute inflammatory response, and the indexes of nutritional status decreased after operation. IL6, CRP and TNFα tested at 3 and 7 days after operation were lower in the study group as compared with those in the control group, and the recovery time of gastrointestinal motility such as borborygmus, gas elimination and defecation was shorter in the study group as compared with that in the control group. The indexes of nutritional status showed no significant differences between two groups after operation. Conclusion:Rhubarb can positively modulate the acute inflammatory response, promote the recovery of postoperative gastrointestinal motility, and benefit enteral nutrition support in patients who have undergone major operations for gastric cancer.
胃癌患者常伴有营养不良，手术治疗后，胃肠道功能处于一种抑制状态，手术创伤诱导的急性炎性反应更加重了其营养不良。术后如何改善患者的营养状况，纠正肿瘤和手术创伤所致的急性炎性反应，实施合理的营养支持成为近年来研究的热点之一。针对胃癌患者围手术期机体代谢的特点，本科在术后常规肠内营养治疗的同时，采用具有清热、解毒、抗炎、抗肿瘤等作用的中药大黄有效地减轻了术后炎性反应，促进了胃肠道功能的恢复，有利于实施术后早期肠内营养支持，兹报告如下。