RESUMO
Objective The clinical benefits of carbohydrate intake 2-3 h before surgery in patients with digestive tract malignant tumor without diabetes mellitus have been confirmed by foreign experts,the"High level evidence" for perioperative nutrition support were also written in China"Guidelines for perioperative nutritional support in adults".However,there are few hospitals in China that prefer preoperative glucose pretreatment,taking into account the differences between domestic and foreign data.In this paper,the clinical randomly controlled experimental data about the effect of preoperative glucose pretreatment on the prognosis of patients with malignant tumor of digestive tract was analyzed by Meta analysis,in order to evaluate the efficacy and safety of preoperative glucose pretreatment in Chinese patients,and to achieve the clinical significance.Methods Retrieving the database from establishment to March 2017,the related literatures about preoperative glucose pretreatment and prognosis of patients with digestive tract malignant tumor were collected.Revman5.3 software was used to perform Meta analysis of 10 randomized controlled trials(606 patients)who met the inclusion criteria.Results Compared with the traditional fasting and non drinking group,the preoperative subjective discomfort of the preoperative group was significantly reduced(SMD = -1.29,95%CI = -2.00--0.59,P = 0.000 3), postoperative insulin resistance was significantly reduced(SMD=-1.92,95%CI=-2.68--1.16,P<0.01), postoperative blood glucose concentration,insulin concentration increased,and no vomiting and aspiration occur in any patient as shown by the literature.Conclusion In the patients with malignant tumor of digestive tract, perioperative nutrition support and pretreatment show significant clinical benefits,preoperative subjective comfort improves,the risk of aspiration does not increase significantly,postoperative insulin resistance decreases.It is proved that preoperative carbohydrate pretreatment is effective and safe in the operation of domestic digestive tract cancer.
RESUMO
Objective To evaluate the efficacy and safety of compound Kushen injection as an adjuvant for chemotherapy in treatment of advanced digestive tract cancer. Methods A prospective, randomized, parallel controlled, single center clinical trial was conducted. One hundred and forty-four patients with advanced gastrointestinal cancer admitted to the Department of Oncology of Fangta Traditional Chinese Medicine (TCM) Hospital of Songjiang District in Shanghai from July 2014 to December 2016 were enrolled, and they were divided into a control group and an observation group, 72 cases in each group. The patients in control group received routine chemotherapy, and on the basis of routine chemotherapy, the patients in the observation group was given compound Kushen injection 20 mL having diluted with 250 mL sodium chloride for intravenous drip, once a day for 14 days constituting 1 therapeutic course. After consecutive 2 therapeutic courses, the clinical efficacy was observed, the differences in disease control rate (DCR), Karnofsky score (KPS), TCM syndrome curative effect and adverse reactions were compared between the two groups, follow-up was carried out for 7-24 months, survival rate and progression free survival (PFS) time was observed in the two groups. Results After treatment, the DCR, KPS score, total effective rate of TCM syndrome in the observation group were significantly higher than those of control group [DCR: 59.7% (43/72) vs. 43.1% (31/72), KPS score: 70.9±6.2 vs. 64.8±4.8, total curative effect of TCM syndrome: 63.89% (46/72) vs. 41.67% (30/72), all P < 0.05], and the adverse effect rate was significantly lower than that of control group [25.0% (18/72) vs. 41.7% (30/72), P < 0.05]. In the end of follow-up, there were 12 survival cases in the control group, and 22 survival cases in observation group, and survival rate and the PFS time in observation group were significantly longer than those in the control group [survival rate: 30.6% vs. 16.7%; PFS time (months): 15.3±4.0 vs. 13.2±4.2, P < 0.05]. Conclusions The therapeutic effect of using Kushen injection as an adjuvant for chemotherapy in treatment of patients with advanced digestive tract cancer is relatively good, can improve the life quality of patients, and lower the incidence of adverse reactions.
RESUMO
Objective To evaluate the efficacy and safety of compound Kushen injection as an adjuvant for chemotherapy in treatment of advanced digestive tract cancer. Methods A prospective, randomized, parallel controlled, single center clinical trial was conducted. One hundred and forty-four patients with advanced gastrointestinal cancer admitted to the Department of Oncology of Fangta Traditional Chinese Medicine (TCM) Hospital of Songjiang District in Shanghai from July 2014 to December 2016 were enrolled, and they were divided into a control group and an observation group, 72 cases in each group. The patients in control group received routine chemotherapy, and on the basis of routine chemotherapy, the patients in the observation group was given compound Kushen injection 20 mL having diluted with 250 mL sodium chloride for intravenous drip, once a day for 14 days constituting 1 therapeutic course. After consecutive 2 therapeutic courses, the clinical efficacy was observed, the differences in disease control rate (DCR), Karnofsky score (KPS), TCM syndrome curative effect and adverse reactions were compared between the two groups, follow-up was carried out for 7-24 months, survival rate and progression free survival (PFS) time was observed in the two groups. Results After treatment, the DCR, KPS score, total effective rate of TCM syndrome in the observation group were significantly higher than those of control group [DCR: 59.7% (43/72) vs. 43.1% (31/72), KPS score: 70.9±6.2 vs. 64.8±4.8, total curative effect of TCM syndrome: 63.89% (46/72) vs. 41.67% (30/72), all P < 0.05], and the adverse effect rate was significantly lower than that of control group [25.0% (18/72) vs. 41.7% (30/72), P < 0.05]. In the end of follow-up, there were 12 survival cases in the control group, and 22 survival cases in observation group, and survival rate and the PFS time in observation group were significantly longer than those in the control group [survival rate: 30.6% vs. 16.7%; PFS time (months): 15.3±4.0 vs. 13.2±4.2, P < 0.05]. Conclusions The therapeutic effect of using Kushen injection as an adjuvant for chemotherapy in treatment of patients with advanced digestive tract cancer is relatively good, can improve the life quality of patients, and lower the incidence of adverse reactions.