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目的探讨黄芪四君子汤联合不同营养方式对肝硬化肝癌大鼠肝部分切除术后营养状态与免疫功能的影响。方法将成功建立肝硬化肝癌大鼠模型并采用Higgins法成功行肝部分切除术的150只大鼠,按随机数字表分为Ⅰ组、Ⅱ组、Ⅲ组,每组50例,Ⅰ组给予常规经口饮食处理,Ⅱ组给予黄芪四君子汤联合肠外营养,Ⅲ组给予黄芪四君子汤联合肠内营养,术前及术后7 d进行营养状态指标〔血红蛋白(Hb)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)〕、免疫功能指标(细胞免疫功能指标、体液免疫功能指标)、免疫细胞因子〔白细胞介素(IL)-2、IL-6、干扰素(INF)-γ〕检测,对三组检测结果进行比较。结果Ⅰ组、Ⅱ组、Ⅲ组术后Hb、TC、TG、LDL均较术前明显降低,但Ⅱ组、Ⅲ组营养状态指标高于Ⅰ组,Ⅲ组营养状态指标高于Ⅱ组。Ⅰ组、Ⅱ组、Ⅲ组术后CD3+、CD4+、CD4+/CD8+均明显低术前,CD8+明显高于术前,Ⅱ组、Ⅲ组术后细胞免疫功能指标明显优于Ⅰ组,Ⅲ组术后细胞免疫功能指标明显优于Ⅱ组。Ⅰ组、Ⅱ组、Ⅲ组术后Ig G、Ig M、Ig A水平均明显低于术前,Ⅱ组、Ⅲ组术后体液免疫功能指标明显优于Ⅰ组,Ⅲ组术后体液免疫功能指标明显优于Ⅱ组。Ⅰ组、Ⅱ组、Ⅲ组术后IL-2、INF-γ均较术前明显升高,Ⅱ组、Ⅲ组术后IL-2、INF-γ明显高于Ⅰ组,Ⅲ组术后IL-2、INF-γ明显高于Ⅱ组,Ⅰ组术后IL-6高于术前,Ⅱ组、Ⅲ组术后IL-6低于术前,Ⅲ组术后IL-6低于Ⅱ组。结论肝硬化肝癌大鼠肝部分切除术后应用黄芪四君子汤联合肠内营养既能改善术后的营养状况,又可提高机体的免疫功能。
Objective To investigate the effects of Astragalus Sijunzi Decoction combined with different nutritional methods on the nutritional status and immune function of liver cirrhosis rats after partial hepatectomy. Methods A total of 150 rats with liver cirrhosis and hepatocellular carcinoma were successfully established and divided into three groups according to random number table: group Ⅰ, group Ⅱ and group Ⅲ, with 50 cases in each group. Group Ⅰ received conventional The rats in group Ⅱ were treated with Astragalus and Sijunzi Decoction combined with parenteral nutrition. Group Ⅲ was treated with Astragalus and Sijunzi Decoction combined with enteral nutrition. The indexes of nutritional status (hemoglobin (Hb), total cholesterol (TC) Triglyceride (TG), low density lipoprotein (LDL)], immune function index (index of cellular immune function, index of humoral immune function), immune cytokines [interleukin (IL) -2, IL-6, interferon (INF) -γ〕 test, the three test results were compared. Results The levels of Hb, TC, TG and LDL in group Ⅰ, group Ⅱ and group Ⅲ after operation were significantly lower than those before operation, but those in group Ⅱ and group Ⅲ were higher than those in group Ⅰ, and those in group Ⅲ were higher than those in group Ⅱ. The levels of CD3 +, CD4 +, CD4 + / CD8 + in group Ⅰ, Ⅱ and Ⅲ were significantly lower than those in group Ⅰ and Ⅱ Post-cellular immune function was significantly better than the group Ⅱ. The levels of Ig G, Ig M and Ig A in group Ⅰ, group Ⅱ and group Ⅲ were significantly lower than those before operation in group Ⅱ and group Ⅲ, and the indexes of humoral immunity were obviously better than those in group Ⅰ and Ⅲ. The humoral immunity Indicators were significantly better than Ⅱ group. The levels of IL-2 and INF-γ in groupⅠ, groupⅡ and groupⅢwere significantly higher than that before operation, and the levels of IL-2 and INF-γ in groupⅡ, Ⅲ were significantly higher than those in groupⅠ, Ⅲ IL-6 and INF-γ were significantly higher in group Ⅰ than those in group Ⅱ, but IL-6 in group Ⅰ was lower than that in group Ⅱ and Ⅲ . Conclusion The application of Astragalus Sijunzi Decoction combined with enteral nutrition after partial hepatectomy in cirrhotic liver cancer rats can not only improve the nutritional status but also improve the immune function.