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目的观察黄芪、角针药对方对结直肠癌患者术后肠道屏障功能的影响。方法以90例经病理确诊为结直肠癌的住院手术患者为研究对象,按随机数字表法分为中药组(予黄芪、角针)、西药组(予丙氨酰-谷氨酰胺二肽)和空白组(予生理盐水)各30例,3组疗程均为8天。观察术前、术后患者的尿乳果糖/甘露醇(lactulose/mannitol,L/M)比值、二胺氧化酶(diamine oxidase,DAO)水平、血D-乳酸水平、内毒素(endotoxin,ET)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)及术后肠鸣音恢复时间。以血D乳酸水平、DAO、L/M为主要药效指标,ET、TNF-α、肠鸣音恢复时间为次要药效指标综合评价该中药对方对结直肠癌患者术后肠道屏障功能的影响。结果中药组尿L/M比值、血D-乳酸、DAO水平与西药组相似(P>0.05),两者均优于空白组(P<0.05);中药组ET、TNF-α下降水平优于西药组,肠鸣音恢复时间短于西药组,差异均有统计学意义(P<0.05,P<0.01);西药组ET、TNF-α下降程度优于空白组(P<0.05),肠鸣音恢复时间与空白组比较,差异无统计学意义(P>0.05)。结论中药对方(黄芪、角针)对结直肠癌患者术后肠道屏障功能损害有一定的保护作用,与西药水平相当。在肠功能恢复、减轻毒素吸收和降低致炎因子水平方面可能优于西药。
Objective To observe the effects of astragalus and angle acupuncture on the intestinal barrier function in patients with colorectal cancer after operation. Methods Ninety hospitalized patients with pathologically diagnosed colorectal cancer were enrolled in this study. The patients were divided into TCM group (Astragalus membranaceus, angle acupuncture) and western medicine group (Ala-glutamine dipeptide) according to random number table. And blank group (normal saline) 30 cases, 3 groups of treatment were 8 days. The ratio of lactulose / mannitol (L / M), diamine oxidase (DAO), blood D-lactate, endotoxin (ET) , Tumor necrosis factor α (TNF-α) and postoperative bowel sound recovery time. D-lactate levels, DAO, L / M as the main pharmacodynamic indicators, ET, TNF-α, bowel sounds recovery time as the secondary efficacy index comprehensive evaluation of the Chinese medicine on colorectal cancer patients with postoperative intestinal barrier function Impact. Results The urinary L / M ratio, blood D-lactate and DAO levels in Chinese medicine group were similar to Western medicine group (P> 0.05), both of which were better than blank group (P <0.05) Western medicine group, bowel sounds recovery time is shorter than the western medicine group, the difference was statistically significant (P <0.05, P <0.01); Western medicine group ET, TNF-αdecreasing degree than the blank group (P <0.05) Sound recovery time and the blank group, the difference was not statistically significant (P> 0.05). Conclusion The traditional Chinese medicine (Astragalus, angle acupuncture) has some protective effect on the intestinal barrier dysfunction in patients with colorectal cancer, which is equivalent to Western medicine. It may be superior to western medicine in terms of intestinal function recovery, reduction of toxin absorption and reduction of the level of inflammatory cytokines.