The Effects Of Ba Zhen Tang Combined With Early Enteral Nutrition (EEN) On The Immune State In Postoperative Esophageal Cancer Patients

[Objective]:To evaluate the effects of traditional chinese medicine Ba Zhen Tang combined with early enteral nutrition(BZT+EEN)on the immune state in postoperative esophageal cancer patients by comparing with conventional EEN[Methods]:Sixty- four patients,who were diagnosed with esophageal cancer in middle or lower esophagus at stageⅠ-Ⅲof the UICC from May 2009 to February 2011 admitted to the thoracic surgery department of General Hospital, were divided into EEN group (32cases) and BZT+EEN group (32cases). There are no significant differences between the two groups in gender, age, surgical methods, operation time, the nature and stage of tumor (P> 0.05). All operations were using general anesthesia. Peripheral blood of patients were taken to measure immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM); and T lymphocyte subsets:CD3, CD4, CD8, CD4/CD8 at time before operation, and 1 day,8 days after operation.Record the postoperative drainage, exhaust time, length of stay,total hospital costs and other clinical parameters, data were statistically analyzed by SPSS13.0.[Results]:A total of 64 patients with two groups were successfully operated. Due to one case of esophageal fistula and one case that postoperative pathology showed keratinized gland cancer,30 cases are accepted in the EEN group actually.Because,in the BZT+EEN group,a patient in the ICU pulled out the feeding tube by manic himself.another patient had suffered from diarrhea and vomiting,30 cases are accepted in BZT+EEN group actually. The two groups in postoperative drainage, length of stay and hospital costs were no significant differences (P>0.05). But the BZT+EEN group in the postoperative recovery of bowel function (discharging time) showed better than the EEN group (P<0.05). In the BZT+EEN group:CD3, CD4, CD4/CD8, IgA, IgG, IgM in postoperative day 1 compared with preoperative levels decreased significantly (P<0.05), However, CD8 was significantly increased compared with the preoperative level (P<0.05); CD3, CD4, CD4/CD8, IgA, IgG, IgM levels were significantly higher than preoperative levels at 8 days after operation(P <0.05),CD8 level was significantly lower than preoperative at 8 days after operation (P<0.05). In the EEN group:CD3, CD4, CD4/CD8, IgA, IgG, IgM in postoperative day 1 compared with preoperative levels decreased significantly (P<0.05), CD8 level was significantly increased compared with the preoperative (P<0.05),8 days after surgery and preoperative level of CD3 was no significant difference (P> 0.05), CD4, CD4/CD8, IgA, IgG, IgM levels were significantly higher than preoperative levels (P<0.05). CD8 level was significantly lower than preoperative level (P<0.05). In postoperative day 1 CD3, CD4, CD8, CD4/CD8 between the two groups was no significant difference with each other (P>0.05),8 days after operation, CD3, CD4, CD4/CD8 levels of the BZT+EEN group were significantly higher than the EEN group (P<0.05), however, CD8 after 8 days showed no significant difference between the two groups (P>0.05); between the two groups on postoperative day 1 IgA, IgG, IgM were no significant difference (P>0.05),8 days after operation, IgA and IgG were no significant difference (P> 0.05).The IgM level of theBZT+EEN group was significantly higher than that of the EEN group (P<0.05).Conclusions:Immune function of postoperative esophageal patients has been certain suppression and damage. Supportive therapy of Ba Zhen Tang combined with EEN can effectively restore and improve the immune function of postoperative esophageal cancer patients, especially in terms of cellular immunity is better than using the EEN, Ba Zhen Tang combined with EEN is conducive to the prevention of postoperative complications, it is good for the surgery of integrated traditional Chinese medicine and can provide a theoretical basis for the development.