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目的观察加味小承气汤对胰十二指肠切除术后患者营养与免疫功能的影响。方法将124例胰十二指肠切除术患者随机分为观察组与对照组各62例。2组患者均在胰十二指肠术后早期给予低剂量的肠内营养与肠外静脉营养联合支持治疗。观察组在此基础上加用小承气汤治疗,对照组同期给予葡萄糖生理盐水。对比观察2组治疗前及治疗后第5天的营养指标(总蛋白、白蛋白、前白蛋白,转铁蛋白,氮平衡)和免疫功能指标[T细胞亚群(CD4+;CD8+;CD4+/CD8+)、免疫球蛋白Ig M、Ig G、Ig A]水平变化。结果治疗前2组营养指标和免疫指标水平差异均无统计学意义(P>0.05)。治疗后观察组各营养指标均高于对照组,观察组CD4+、CD8+、CD4+/CD8+水平和Ig M、Ig G、Ig A水平高于对照组,差异均有统计学意义(P<0.01)。结论早期加味小承气汤配合肠内、外营养支持治疗可明显改善胰十二指肠切除术后患者营养指标,增强机体免疫功能,提高患者的临床疗效。
Objective To observe the effect of Jiawei Xiao Chengqi Decoction on nutrition and immune function in patients after pancreatoduodenectomy. Methods 124 cases of pancreatoduodenectomy were randomly divided into observation group and control group of 62 cases. Both groups were given low-dose enteral nutrition combined with parenteral nutrition support in the early postoperative period of pancreaticoduodenal surgery. On the basis of this observation group, Xiao Cheng Qi Decoction was used, while the control group was given glucose saline. To compare the nutritional indexes (total protein, albumin, prealbumin, transferrin, nitrogen balance) and immune function indexes (T cell subsets (CD4 +; CD8 +; CD4 + / CD8 + ), Immunoglobulin Ig M, Ig G, Ig A] levels. Results Before treatment, there was no significant difference between the two groups in nutritional index and immune index (P> 0.05). After treatment, the nutritional indexes in the observation group were higher than those in the control group. The levels of CD4 +, CD8 +, CD4 + / CD8 + and IgM, Ig G, IgA in the observation group were higher than those in the control group (P <0.01). Conclusion Early Modified Xiao Chengqi Decoction combined with enteral and external nutritional support therapy can significantly improve nutritional indicators of patients after pancreatoduodenectomy, enhance immune function and improve the clinical efficacy of patients.