摘要
目的:探讨六君子汤加减对晚期胃癌气血亏虚证免疫功能、营养状况及肠道微生态的调节作用。方法:将86例晚期胃癌气血亏虚证患者按入院单双号随机分对照组和观察组,每组43例。在基础治疗基础上,对照组给予益气养血口服液;观察组给予六君子汤加减治疗。4周后,比较两组患者的临床疗效,中医证候评分,胃肠功能恢复情况,毒副反应及生活质量,免疫功能,T细胞亚群CD3^(+),CD4^(+),CD8^(+),补体C3,C4水平,免疫球蛋白A(Ig A),免疫球蛋白G(Ig G),免疫球蛋白M(Ig M),营养状况,白蛋白(Alb),前白蛋白(PA),血清总蛋白(TP)及血红蛋白(Hb)含量变化,肠道微生态:双歧杆菌、乳酸杆菌、粪肠球菌、大肠埃希菌含量变化。结果:观察组总有效率为95.35%(41/43)显著高于对照组的79.07%(34/43)(χ^(2)=5.108,P<0.05);治疗后,观察组头晕眼花、面色无华、心悸气短、神疲等中医证候评分均明显低于对照组(P<0.05);观察组的肠鸣音恢复、排气和排便时间显著低于对照组(P<0.05);观察组天人相应、形神一体、特异模块、功能领域和总体健康评分等生活质量评分明显高于对照组(P<0.05);观察组CD3^(+),CD4^(+),CD4^(+)/CD8^(+),C3,C4,Ig A,Ig G,Ig M等免疫功能指标均明显高于对照组,CD8^(+)水平低于对照组(P<0.05);观察组Alb,PA,TP和Hb等营养状况水平明显高于对照组(P<0.05);观察组双歧杆菌、乳酸杆菌和粪肠球菌高于对照组,大肠埃希菌低于对照组(P<0.05);观察组患者的不良反应发生率为11.63%(5/43)与对照组的16.28%(7/43)差异无统计学意义。结论:六君子汤加减对晚期胃癌气血亏虚证患者具有较好的临床疗效,可改善中医证候和胃肠功能,提高生活质量,其机制与提高免疫功能,增强营养状况,改善肠道微生态有关,且具有较好的安全性。
Objective:To explore the regulatory effect of modified Liu Junzitang on the immune function,nutritional status and intestinal microecology in advanced gastric cancer patients with syndrome of deficiency of Qi and blood.Method:The 86 advanced gastric cancer patients with syndrome of deficiency of Qi and blood were randomly divided into control group and observation group according to their admission numbers,with 43 cases in each group.The control group was given Yiqi Yangxue oral liquid on the basis of basic treatment while the observation group was given modified Liu Junzitang.After 4 weeks,compare the clinical efficacy of two groups of patients,traditional Chinese medicine(TCM) syndrome score,gastrointestinal function recovery,adverse reaction and quality of life,immune function,T cell subsets CD3^(+),CD4^(+),CD8^(+),C3and C4levels,immunoglobulin A(Ig A),immunoglobulin G(Ig G),immunoglobulin M(Ig M),nutritional status:albumin(propagated),prealbumin(PA),serum total protein(TP)and hemoglobin(Hb)content changes,the intestinal micro ecology:Bifidobacterium,Lactobacillus,Enterococcus aureus,Escherichia coli content changes.Result:The total effective rate of the observation group was 95.35%(41/43),which was significantly higher than 79.07%(34/43)of the control group(χ^(2)=5.108,P<0.05),after treatment,the TCM syndromes such as dizziness,pale complexion,palpitation,shortness of breath and fatigue in the observation group were significantly lower than those in the control group(P<0.05),the bowel sound recovery,exhaust and defecation time of the observation group were significantly lower than those of the control group(P<0.05),the quality of life scores in the observation group,such as the nature-to-human correspondence,form and spirit integration,specific modules,functional areas,and overall health score,were significantly higher than those in control group(P<0.05),the CD3^(+),CD4^(+),CD4^(+)/CD8^(+),C3,C4,Ig A,immune function indexes such as Ig G and Ig M were significantly higher than those of the control group,and the CD8^(+)level was lower than which of control group(P<0.05),the nutritional status levels such as Alb,PA,TP and Hb in the observation group were significantly higher than those of the control group(P<0.05),Bifidobacterium,Lactobacillus,and E.faecalis in the observation group were higher than those in the control group,and E.coli was lower than the control group(P<0.05),the adverse reaction rate of the observation group was 11.63%(5/43)and the control group was16.28%(7/43),and there was no statistical difference between two groups.Conclusion:Modified Liu Junzitang has a good clinical effect on advanced gastric cancer patients with syndrome of deficiency of Qi and blood.It can improve TCM syndromes and gastrointestinal function,improve quality of life,and its mechanism is related to improving immune function,enhancing nutritional status,and improving intestinal microecology,and it has good safety.
作者
程硕
张行行
梁琳
张吉发
陆艳
李泽栋
CHENG Shuo;ZHANG Xing-xing;LIANG Lin;ZHANG Ji-fa;LU Yan;LI Ze-dong(Anhui University of Science and Technology,Huainan 232001,China;South Branch of the Sixth People's Hospital of Shanghai Jiaotong Universily,Shanghai 201499,China;Liqun Hospital of Putuo District of Shanghai,Shanghai 201433,China;The First Affiliated Hospital ofAnhui Universily of Chinese Medicine,Hefei 230012,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2021年第5期98-104,共7页
Chinese Journal of Experimental Traditional Medical Formulae
基金
安徽省自然科学基金项目(1808085MH211)
上海市卫生健康委课题项目(20184Y0104)
上海市奉贤区科学技术发展基金项目(奉科20131420)。
关键词
六君子汤加减
晚期胃癌
气血亏虚证
免疫功能
营养状况
肠道微生态
modified Liu Junzitang
advanced gastric cancer
syndrome of deficiency of Qi and blood
immune function
nutritional status
intestinal microecology
