加味通腑汤对胃癌术后早期患者胃肠功能和营养状况的影响

目的 观察加味通腑汤联合肠内外营养对胃癌术后早期患者胃肠功能恢复和营养状况的改善作用。方法 将62例胃癌术后患者随机分为对照组与观察组，每组31例。在术后常规处理基础上，对照组给予肠内外营养支持，观察组在肠内外营养支持基础上给予加味通腑汤经鼻空肠营养管滴注。比较两组患者术后首次排气时间和首次排便时间，术前1 d、术后3 d和术后7 d前白蛋白（prealbumin，PA）、白蛋白（albumin，Alb）、血清总蛋白（total serum protein，TP）及血红蛋白（hemoglobin，Hb）水平，同时观察患者术后腹胀、恶心呕吐、肺部感染、腹腔感染、吻合口瘘等并发症发生情况。结果 与对照组比较，观察组患者术后首次排气时间和首次排便时间显著缩短（P＜0.05）；术后3 d，两组患者PA、Alb、TP、Hb均较术前1 d显著降低（P＜0.05）；术后7 d，两组患者PA、Alb、TP、Hb均较术后3 d显著升高（P＜0.05），且观察组患者PA、Alb、TP、Hb均明显高于对照组（P＜0.05）；观察组患者术后并发症的发生率明显低于对照组（P＜0.05）。结论 胃癌术后早期肠内外营养支持联合加味通腑汤小肠内滴注，可以促进胃肠功能恢复，改善营养状况，降低术后并发症的发生率。

Effect of Jiawei Tongfu Decoction on Gastrointestinal Function and Nutritional Status in the Early Stage after Surgery for Gastric Cancer

Objective To investigate the effect of Jiawei Tongfu Decoction combined with enteral-parenteral nutrition on the recovery of gastrointestinal function and the improvement of nutritional status in the early stage after surgery for gastric cancer. Methods A total of 62 patients who underwent surgery for gastric cancer were randomly divided into control group and observation group, with 31 patients in each group. In addition to conventional treatment after surgery, the patients in the control group were given enteral-parenteral nutrition support, and those in the observation group were given the dripping of Jiawei Tongfu Decoction via the nasal-jejunum nutrition tubebased on the enteral-parenteral nutrition support in the control group. The two groups were compared in terms of time to first flatus and time to first defecation after surgery and the levels of prealbumin(PA), albumin(Alb), total serum protein(TP), and hemoglobin(Hb) on day 1 before surgery and days 3 and 7 after surgery, and the postoperative complications, such as abdominal distension, nausea and vomiting, pulmonary infection, abdominal infection, and anastomotic leak, were also observed. Results Compared with the control group, the observation group had significantly shorter time to first flatus and time to first defecation after surgery (P<0.05). Both groups had significant reductions in PA,Alb,TP, and Hb from day 1 before surgery to day 3 after surgery (P<0.05) and significant increases in these indices from day 3 to day 7 after surgery (P<0.05), and the observation group had significantly higher PA,Alb,TP, and Hb than the control group (P<0.05). The observation group had a significantly lower overall incidence rate of postoperative complications than the control group (P<0.05). Conclusion In the early stage after surgery for gastric cancer, enteral-parenteral nutrition support combined with intra-small intestine dripping of self-made Jiawei Tongfu Decoction can promote the recovery of gastrointestinal function, improve nutritional status, and reduce the incidence rate of postoperative complications.