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目的:探讨不同剂量生大黄鼻饲对胃肠肿瘤病人术后炎性反应和免疫功能的影响。方法:将150例病人分为五组,每组30例。用常规方法治疗,1~4组为试验组,5组为对照组。病人于术后6 h开始从鼻胃管滴入生大黄溶液,剂量分别为0.3、0.6、0.9和1.2 g/(kg·d),1次/12 h,持续至术后第2天。于术前l d、术后第1和第3天检测病人外周血清中的炎性指标(CRP、IL-6)和免疫功能指标(CD3~+、CD4~+、CD8~+和CD4~+/CD8~+比值)等。结果:各组病人手术后CRP、IL-6值均较术前明显升高,应用生大黄组CRP,IL-6值较对照组明显降低,差异有显著性统计学意义(P<0.05),其中试验3组和4组优于试验1组和2组,差异亦有显著性统计学意义(P<0.05)。各组病人手术后第1天,CD3~+、CD4~+和CD4~+/CD8~+比值均明显降低,与术前比差异有显著性统计学意义(P<0.05)。术后第3天各试验组上述指标呈回升趋势,其中试验3组和4组与试验5组比,差异有显著性统计学意义(P<0.05)。结论:生大黄不仅可降低胃肠肿瘤病人术后的炎性反应,而且还能增强病人的免疫功能。
Objective: To investigate the effects of nasal feeding with different dosages on postoperative inflammatory reaction and immune function in patients with gastrointestinal tumors. Methods: 150 patients were divided into five groups, 30 cases in each group. Treatment with conventional methods, 1 to 4 groups for the experimental group, 5 groups for the control group. The patient started to drip the rhubarb solution from the nasogastric tube at 6 h after operation at dosages of 0.3, 0.6, 0.9 and 1.2 g / (kg · d), once / 12 h, respectively, until the second day after operation. The levels of inflammatory markers (CRP, IL-6) and immune function indicators (CD3 +, CD4 +, CD8 + and CD4 + / CD8 + CD8 ~ + ratio) and so on. Results: The CRP and IL-6 levels of patients in each group were significantly higher than those before operation. The CRP and IL-6 levels of the patients receiving rhubarb were significantly lower than those of the control group (P <0.05) Thereinto, the experimental groups 3 and 4 were superior to the experimental groups 1 and 2, the difference was also statistically significant (P <0.05). On the first day after operation, the ratios of CD3 ~ +, CD4 ~ + and CD4 ~ + / CD8 ~ + in all groups were significantly decreased, which were significantly different from those before operation (P <0.05). On the third day after operation, the above indexes showed a rising trend. Among the three groups and four groups, the difference between the three groups was statistically significant (P <0.05). Conclusion: Rhubarb can not only reduce the postoperative inflammatory reaction of patients with gastrointestinal tumors, but also enhance the patient’s immune function.