ABSTRACT
Objective To explore the effects of Yiqi Jianpi decoction on inflammatory reaction, immune function and nutritional status in patients after surgery of laparoscopic rectal cancer. Methods Eighty-two patients with post-operative laparoscopic rectal cancer resection admitted to Pingxiang People's Hospital from June 2017 to March 2019 were enrolled, and according to whether traditional Chinese medicine (TCM) was used or not, they were divided into a western medicine treatment control group (control group) and a combined traditional Chinese and western medicine treatment group (combined group), 41 cases in each group. The control group was treated with symptomatic conventional western therapy, while the combined group was additionally treated with Yiqi Jianpi decoction based on the conventional western treatment as in the control group; the composition of the decoction: hedyotis herba, herba agrimoniae, radix astragali each 30 g; radix codonopsis, ganoderma lucidum each 20 g; rizoma atractylodes, poria cocos and prunella chinensis 15 g each; pinellia ternata 9 g, licorice root 6 g; all the above ingredients were together boiled with water and the fluid (decoction) was filtered, 150 mL once orally taken, twice a day, 21 days constituting one therapeutic course, and the clinical efficacy was evaluated after 1 course of therapy. The changes of TCM syndrome score, simple health situation scale (SF-36) score, inflammatory indexes, immune function and nutritional status of the two groups were observed before and after treatment. Results After treatment, the levels of TCM syndrome score, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and CD8+ in the two groups were significantly lower than those before treatment, while the levels of SF-36 score, CD4+, CD4+/CD8+, transferrin (TRF) and albumin (Alb) were significantly higher than those before treatment (all P < 0.05), and the degree of changes in the combined group were more significant than those in control group [TCM syndrome score: 3.79±2.22 vs. 6.86±2.02, SF-36 score:75.18±4.13 vs. 64.17±4.01, CRP (mg/L): 4.54±1.31 vs. 5.71±2.21, IL-6 (μg/L): 20.21±2.21 vs. 26.12±2.13, TNF-α (μg/L): 33.04±4.56 vs. 36.41±3.23, CD4+: 0.37±0.03 vs. 0.35±0.03, CD8+: 0.25±0.03 vs. 0.28±0.03, CD4+/CD8+: 1.51±0.39 vs. 1.19±0.37, TRF (g/L): 3.05±0.41 vs. 2.28±0.42, Alb (g/L): 43.88±2.28 vs. 39.86±2.03, all P < 0.05]. Conclusion Yiqi Jianpi decoction in the treatment of patients after surgery of laparoscopic rectal cancer can effectively promote the recovery of gastrointestinal function, reduce the inflammatory reaction, elevate the immune function and improve clinical prognosis.
ABSTRACT
Objective To explore the application and analysis of E-PASS scoring system for orthopaedic senile hip surgery risk assessment. Methods Retrospectively analyzed the data of 188 cases of elderly hip fracture patients with anesthesia and surgery, postoperative complications. Useing E-PASS scoring system to evaluate the mortality of patients with surgical risk. Results Postoperative complications mainly was respiratory system diseases, the rate of complication was 25.88%(22/85), accounting for total cases rate was 11.70% (22/188). Secondly for cardiovascular diseased and urinary system diseases. E-PASS scoring system showed that the scores of surgery risk assessment in patients with complication was significantly higher than that without complication:(0.27±0.23) scores vs. (0.17±0.16) scores, t=3.728, P<0.05. Ninety-one patients were evaluated to occur complications by E-PASS grading system, 85 patients occurred practically,the rate of actual value/forecast was 0.93.Six patients were evaluated to die, 2 patients occurred practically, the rate of actual value/forecast was 0.33, there were no significant differences ( P=0.056,0.124). Conclusion E-PASS scoring system for orthopaedic senile hip surgery risk assessment can predict the risk of complication and death effectively,it is value of interventing the preoperative risk factors and has great clinical application value.