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目的:评价肠内免疫营养对食管癌患者化疗所致脾虚证的影响。方法:30例食管癌化疗病人随机分空白对照组、肠内免疫营养组和中药组三组,研究观察各组治疗后脾虚证积分、营养状态及T细胞亚群变化。结果:三组化疗后脾虚积分均有升高,以空白对照组最明显(P<0.05),肠内免疫营养和中药两组差异不明显(P>0.05);营养状态:化疗后第7天三组前白蛋白、转铁蛋白较化疗前均显著降低(P<0.05),第14、21天肠内免疫营养组前白蛋白、转铁蛋白显著优于空白对照组和中药组(P<0.05);T细胞亚群:化疗前后辅助性T细胞(CD4+)及CD4+/CD8+比值空白对照组明显下降(P<0.05);肠内免疫营养组和中药组反而上升(P<0.05)。结论:抗肿瘤化疗可影响中医证侯,使食管癌患者出现或加重脾虚证,肠内免疫营养可减轻或改善患者脾虚证,提高患者的营养状态,增强患者机体免疫力。
Objective: To evaluate the effect of enteral immunonutrition on spleen-deficiency syndrome induced by chemotherapy in esophageal cancer patients. Methods: Thirty patients with chemotherapy of esophageal cancer were randomly divided into blank control group, enteral immunization group and traditional Chinese medicine group. The changes of spleen deficiency syndrome score, nutrition status and T cell subsets were observed after treatment. Results: The scores of spleen deficiency in all three groups were increased after chemotherapy, the most obvious was the blank control group (P <0.05), the difference between intestinal immune nutrition and traditional Chinese medicine was not significant (P> 0.05); Nutritional status: The albumin and transferrin in the three groups were significantly lower than those before chemotherapy (P <0.05). Prealbumin and transferrin in enteral immunization group on day 14 and 21 were significantly better than those on blank control group and traditional Chinese medicine group (P < 0.05). T cell subsets: The levels of CD4 + and CD4 + / CD8 in the T cell subsets were significantly decreased (P <0.05) before and after chemotherapy; but increased in the group of ENK and TCM (P <0.05). Conclusion: The anti-tumor chemotherapy can affect the syndrome of traditional Chinese medicine, so that patients with esophageal cancer appear or aggravate spleen deficiency syndrome, intestinal immune nutrition can reduce or improve the patients with spleen deficiency syndrome, improve the nutritional status of patients and enhance the patient’s immunity.