| Objective Severe surgical injury often results in decreased immune function, increased intestinal mucosal permeability and impaired intestinal mucosal barrier function, leading to vulnerability to general infection, systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) in patients with disease such as gastric carcinoma; it also has effect on the recurrence of tumor and prognosis of the disease. To observe the protective effect of Chinese medicine herbs on immune system and intestinal barrier function for postoperative patients with gastric carcinoma treated with early enteral nutrition supplemented with Chinese medicine herbs, this study try to evaluate whether the treatment can improve patients' immune function and have some protective effect on intestinal barrier function or not. Method 60 patients were randomly divided into study group (30 cases) and control group (30 cases). The study group were dripped with Chinese Jianpi Tongli herbs via the silicon catheters intubated into small intestine from the first day to the seventh day postoperatively; while the control group were dripped with 0.9% sodium chloride. Two groups were given enteral nutrition support on the second day after operation. We checked (1) cellular immune function, the observation parameters including serum interleukin-2 (IL-2), soluble interleukin-2 receptor (sIL-2R) and interleukin-12 (IL-12) before and after surgery; (2) intestinal mucosal permeability: lactulose and mannitol excretion ratio in urine and serum endotoxin. Results This study showed : (l)Changes of serum IL-2 levels: the level of IL-2was 209.97 ±54.12pg/ml on the day before operation, 215.97±45.97ug/ml on the first day after operation, and 231.62±39.37|jg/ml on the seventh day after operation in the study group; the level of IL-2 in the control group was 211.00 ± 64.45Mg/ml on the day before operation, 208.07 ± 47.37ug/ml and 216.29 ± 37.87|jg/ml on the first day and the seventh day after operation. The level of IL-2 in the study group were significantly higher on the seventh day after operation than the control group (P<0.05) and it's preoperative level(P<0.05). (2)The changes of serum IL-12 levels: the concentration of IL-12 was 230.79 ± 43.883U/ml on day before operation and 221.79±45.04U/ml,208.07±47.37U/ml on the first and the seventh day after operation respectively in the study group; ■the concentration of IL-12 in the control group was 233.79±58.46U/ml on the day before operation and 225.14 ± 47.79,244.71 ±48.21U/ml on the first and the seventh day after operation. There was no significant difference of the concentration of IL-12 between the two group on the seventh day after operation(P<0.05), but the serum concentration of IL-12 was higher on the seventh day after operation than on the day before operation in the study group(P<0.05).(3) Changes of serum sIL-2R levels: the level of SIL-2R was 339.66±67.60 Pg/ml on the day before operation, 347.00±84.47 Pg/ml on the first day after operation, and 305.41±55.34 Pg/ml on the seventh day after operation in the study group; the level of sIL-2R in the control group was 341.75±75.81 Pg/ml on the day before operation, 343.68±78.39 Pg/ml and 330.50±68.17 Pg/ml on the first day and the seventh day after operation. The level of SIL-2R in the study group were significantly higher on the seventh day after operation than the control group (P<0.05) and ifs preoperative level(P<0.05). (4)Excretion rate of urine L/M was 0.02860 ±0.007485 on the day before operation and 0.0291410.007417 on the fifth day after operation in the study group; in the control group it was 0.031123±0.007980 and 0.04939±... |
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