补阳还五汤加减对胃肠道恶性肿瘤患者术后凝血功能及炎性因子的影响
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摘要
目的:探讨补阳还五汤加减对胃肠道恶性肿瘤患者术后凝血功能及炎性因子的影响。方法:将接受手术治疗的胃肠道恶性肿瘤患者60例采用随机数字表法分为2组各30例。对照组采用常规方法治疗,观察组在常规治疗的基础上联合补阳还五汤加减治疗,2组均连续治疗15天。分别检测2组患者治疗前后凝血功能指标[纤维蛋白原(FIB)、凝血活酶时间(APTT)、凝血酶原时间(PT)、血小板计数(BPC)]和血清炎性因子[白细胞介素-2 (IL-2)、IL-6、肿瘤坏死因子-α(TNF-α)、前列腺素E2(PGE_2)]水平的变化情况。记录并统计2组治疗后不良反应发生率。结果:2组治疗前PT、APTT、FIB、BPC水平比较,差异无统计学意义(P> 0.05)。2组治疗后PT、APTT水平高于治疗前,FIB、BPC水平低于治疗前(P <0.05);观察组治疗后PT、APTT水平高于对照组,FIB、BPC水平低于对照组(P <0.05)。2组治疗前IL-2、IL-6、TNF-α、PGE2水平比较,差异无统计学意义(P> 0.05);2组治疗后IL-2、IL-6、TNF-α、PGE_2水平低于治疗前(P <0.05);观察组治疗后IL-2、IL-6、TNF-α、PGE_2水平低于对照组(P <0.05)。不良反应发生率观察组10.00%,对照组为13.33%,2组比较,差异无统计学意义(χ~2=1.583,P> 0.05)。结论:补阳还五汤用于胃肠道恶性肿瘤术后术后效果理想,有助于改善患者凝血功能,降低血清炎性因子水平,且药物安全性较高。
Objective: To discuss the effect of modified Buyang Huanwu tang on the function of coagulation and fibrinolysis and levels of serum inflammatory factors of postoperative patients with gastrointestinal malignant tumor. Methods:60 cases of patients with gastrointestinal malignant tumor who received surgery for treatment were divided into two groups randomly,30 cases in each group. The control group received the routine treatment,while the observation group additionally received modified Buyang Huanwu tang. The treatment for both groups lasted for 15 days. Detected the changes of indexes of coagulation and fibrinolysis [fibrinogen(FIB), activated partial thromboplastin time(APTT),prothrombin time(PT),blood platelet count(BPC)] and levels of serum inflammatory factors [interleukin-2(IL-2), IL-6, tumor necrosis factor-α(TNF-α),prostaglandin E2(PGE_2)] of patients in both groups before and after treatment. Recorded and statistically analyzed the incidence of adverse reactions in both groups. Results: Before treatment, comparing the levels of PT, APTT, FIB and BPC in-between the two groups,there was no significant difference being found(P > 0.05). After treatment,the levels of PT and APTT in both groups were higher than those before treatment,and the levels of FIB and BPC were lower than those before treatment(P < 0.05);the levels of PT and APTT in the observation group were higher than those in the control group,and the levels of FIB and BPC were lower than those in the control group(P < 0.05). Before treatment,comparing the levels of IL-2,IL-6, TNF-α and PGE_2 in-between the two groups, there was no significant difference being found(P > 0.05). After treatment,the levels of IL-2,IL-6,TNF-α and PGE_2 in both groups were lower than those before treatment(P < 0.05);the levels of IL-2,IL-6,TNF-α and PGE_2 in the observation group were lower than those in the control group(P < 0.05).The incidence of adverse reactions was 10.00% in the observation group and 13.33% in the control group,difference being insignificant(χ~2= 1.583,P > 0.05). Conclusion:The application of modified Buyang Huanwu tang has optimal clinical effect in treating postoperative patients with gastrointestinal malignant tumor. It helps improve the function of coagulation function and reduce the levels of serum inflammatory factors with high medicine safety.
Objective: To discuss the effect of modified Buyang Huanwu tang on the function of coagulation and fibrinolysis and levels of serum inflammatory factors of postoperative patients with gastrointestinal malignant tumor. Methods:60 cases of patients with gastrointestinal malignant tumor who received surgery for treatment were divided into two groups randomly,30 cases in each group. The control group received the routine treatment,while the observation group additionally received modified Buyang Huanwu tang. The treatment for both groups lasted for 15 days. Detected the changes of indexes of coagulation and fibrinolysis [fibrinogen(FIB), activated partial thromboplastin time(APTT),prothrombin time(PT),blood platelet count(BPC)] and levels of serum inflammatory factors [interleukin-2(IL-2), IL-6, tumor necrosis factor-α(TNF-α),prostaglandin E2(PGE_2)] of patients in both groups before and after treatment. Recorded and statistically analyzed the incidence of adverse reactions in both groups. Results: Before treatment, comparing the levels of PT, APTT, FIB and BPC in-between the two groups,there was no significant difference being found(P > 0.05). After treatment,the levels of PT and APTT in both groups were higher than those before treatment,and the levels of FIB and BPC were lower than those before treatment(P < 0.05);the levels of PT and APTT in the observation group were higher than those in the control group,and the levels of FIB and BPC were lower than those in the control group(P < 0.05). Before treatment,comparing the levels of IL-2,IL-6, TNF-α and PGE_2 in-between the two groups, there was no significant difference being found(P > 0.05). After treatment,the levels of IL-2,IL-6,TNF-α and PGE_2 in both groups were lower than those before treatment(P < 0.05);the levels of IL-2,IL-6,TNF-α and PGE_2 in the observation group were lower than those in the control group(P < 0.05).The incidence of adverse reactions was 10.00% in the observation group and 13.33% in the control group,difference being insignificant(χ~2= 1.583,P > 0.05). Conclusion:The application of modified Buyang Huanwu tang has optimal clinical effect in treating postoperative patients with gastrointestinal malignant tumor. It helps improve the function of coagulation function and reduce the levels of serum inflammatory factors with high medicine safety.
引文
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[9]杨欢,郑小兰,徐国海,等.电针刺激对糖尿病患者术后认知功能及血清炎性因子的影响[J].临床麻醉学杂志,2015,31(11):1073-1076.
[10]张绍刚,王星明,孙振全,等.髋关节置换术老年患者术后谵妄与术前脑脊液及血清炎性因子水平的关系[J].中华麻醉学杂志,2015,35(1):119-120.
[11]Ishizuka M,Shibuya N,Nagata H,et al.Perioperative administration of traditional Japanese herbal medicine daikenchuto relieves postoperative ileus in patients undergoing surgery for gastrointestinal cancer:A systematic review and meta-analysis[J].Anticancer Res,2017,37(11):5967-5974.
[12]胡国强,陈威.含ω-3鱼油脂肪乳的肠外营养液对胃肠道肿瘤病人术后免疫与炎性因子的影响[J].肠外与肠内营养,2015,22(1):16-19.
[13]符小玉,陈小芬,林白浪,等.开放性创伤手术切口感染患者血清炎性因子水平变化分析[J].中华医院感染学杂志,2017,27(2):351-354.
[14]潘钢,周卫东,舒洪娟.老年胃癌围术期血清IL-2、CEA和CA72-4水平测定的临床意义[J].内蒙古医学杂志,2014,46(8):970-972.
[15]Zhang XK,Chen QH,Wang WX,et al.Evaluation of dexmedetomidine in combination with sufentanil or butorphanol for postoperative analgesia in patients undergoing laparoscopic resection of gastrointestinal tumors:A quasiexperimental trial[J].Medicine,2016,95(50):e5604.
[16]杨斌,张建武.酶联免疫吸附法测定肿瘤性贫血患者的血清细胞因子水平及其发病机制研究[J].中国临床药理学杂志,2017,33(12):1102-1105.
[2]张寅,朱静.胸部恶性肿瘤患者开胸手术前后血清内脏蛋白和炎性细胞因子水平变化的意义[J].放射免疫学杂志,2013,26(6):709-711.
[3]黎镭,张彦峰.腹部恶性肿瘤患者深静脉血栓手术期间血清炎症因子水平的变化及其临床意义[J].泰山医学院学报,2017,38(3):314-316.
[4]Masaki K,Hidaka S,Tominaga T,et al.Abstract 4939:Evaluating a novel biomarkers set for postoperative outcome in patients with gastrointestinal cancer[J].Cancer Research,2016,76(14 Supplement):4939.
[5]朱翠凤,刘晓平,白植军,等.生态免疫营养对消化道恶性肿瘤患者术后营养状况、炎症反应和预后的影响[J].中国临床营养杂志,2007,15(2):90-94.
[6]杨易,王存川,龚瑾,等.腹腔镜手术与传统开腹手术对老年结肠癌患者血清炎性因子水平及远期疗效的影响[J].疑难病杂志,2017,16(7):698-701,705.
[7]中华人民共和国卫生部.中国常见恶性肿瘤诊治规范(第6册)[M].北京:北京医科大学出版社,1991:2725-2736.
[8]周仲瑛.中医内科学[M].2版.北京:中国中医药出版社,2007:446.
[9]杨欢,郑小兰,徐国海,等.电针刺激对糖尿病患者术后认知功能及血清炎性因子的影响[J].临床麻醉学杂志,2015,31(11):1073-1076.
[10]张绍刚,王星明,孙振全,等.髋关节置换术老年患者术后谵妄与术前脑脊液及血清炎性因子水平的关系[J].中华麻醉学杂志,2015,35(1):119-120.
[11]Ishizuka M,Shibuya N,Nagata H,et al.Perioperative administration of traditional Japanese herbal medicine daikenchuto relieves postoperative ileus in patients undergoing surgery for gastrointestinal cancer:A systematic review and meta-analysis[J].Anticancer Res,2017,37(11):5967-5974.
[12]胡国强,陈威.含ω-3鱼油脂肪乳的肠外营养液对胃肠道肿瘤病人术后免疫与炎性因子的影响[J].肠外与肠内营养,2015,22(1):16-19.
[13]符小玉,陈小芬,林白浪,等.开放性创伤手术切口感染患者血清炎性因子水平变化分析[J].中华医院感染学杂志,2017,27(2):351-354.
[14]潘钢,周卫东,舒洪娟.老年胃癌围术期血清IL-2、CEA和CA72-4水平测定的临床意义[J].内蒙古医学杂志,2014,46(8):970-972.
[15]Zhang XK,Chen QH,Wang WX,et al.Evaluation of dexmedetomidine in combination with sufentanil or butorphanol for postoperative analgesia in patients undergoing laparoscopic resection of gastrointestinal tumors:A quasiexperimental trial[J].Medicine,2016,95(50):e5604.
[16]杨斌,张建武.酶联免疫吸附法测定肿瘤性贫血患者的血清细胞因子水平及其发病机制研究[J].中国临床药理学杂志,2017,33(12):1102-1105.