姚望, 张鑫杰, 姚庆华. 胃肠道恶性肿瘤化疗患者早期肠内营养干预的临床研究[J]. 中国肿瘤临床, 2019, 46(15): 780-784. DOI: 10.3969/j.issn.1000-8179.2019.15.514
引用本文: 姚望, 张鑫杰, 姚庆华. 胃肠道恶性肿瘤化疗患者早期肠内营养干预的临床研究[J]. 中国肿瘤临床, 2019, 46(15): 780-784. DOI: 10.3969/j.issn.1000-8179.2019.15.514
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Yao Wang, Zhang Xinjie, Yao Qinghua. Clinical study of the effect of early enteral nutrition intervention in patients with gastrointestinal malignant tumors undergoing chemotherapy[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(15): 780-784. DOI: 10.3969/j.issn.1000-8179.2019.15.514
Citation: Yao Wang, Zhang Xinjie, Yao Qinghua. Clinical study of the effect of early enteral nutrition intervention in patients with gastrointestinal malignant tumors undergoing chemotherapy[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(15): 780-784. DOI: 10.3969/j.issn.1000-8179.2019.15.514
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胃肠道恶性肿瘤化疗患者早期肠内营养干预的临床研究

Clinical study of the effect of early enteral nutrition intervention in patients with gastrointestinal malignant tumors undergoing chemotherapy

    摘要
  • 摘要:
      目的  评价肠内营养对胃肠道恶性肿瘤化疗患者不良反应、营养状况、免疫功能、肠道屏障功能和肠道菌群的影响。
      方法  选取2018年3月至2018年11月浙江省肿瘤医院46例接受含5-氟尿嘧啶化疗的胃肠道恶性肿瘤患者随机分为对照组和试验组，每组各23例，对照组行单纯化疗治疗，试验组在其基础上辅以肠内营养支持治疗。观察两组患者随化疗疗程的增加其不良反应、营养状况、免疫功能、肠道屏障功能以及肠道菌群的动态变化。
      结果  1）不良反应：与对照组相比，试验组的恶心、呕吐及总的不良反应例数较少（P < 0.05）；2）营养状况：随化疗次数增加，试验组中前清蛋白（prealbumin，PA）和转铁蛋白（transferrin，TF）呈上升趋势，对照组则呈下降趋势（P < 0.05）；3）T细胞亚群：随化疗次数增加，试验组中CD3+、CD4+和CD4+/CD8+呈上升趋势，与对照组相比增加明显（P < 0.05）；4）免疫球蛋白：试验组中IgG、IgA、C4较对照组增加明显（P < 0.05）；5）肠道屏障功能：在第4~6个疗程中，对照组D-乳酸和二胺氧化酶的指标较试验组相比明显增高（P < 0.05）；6）肠道菌群：随化疗疗程增加，对照组中乳酸杆菌和双歧杆菌数量较试验组相比明显减少（P < 0.05），肠杆菌和肠球菌与试验组相比明显增多（P < 0.05）。
      结论  肠内营养可降低患者化疗不良反应、改善营养状况及机体的免疫功能，减轻肠道屏障功能损伤和改善肠道菌群失调。

     

    Abstract:
      Objective  To evaluate the effects of enteral nutrition on adverse reactions, nutritional status, immune function, intestinal barrier function, and intestinal flora in patients with gastrointestinal malignant tumors.
      Methods  Fron March 2018 to November 2018, forty-six patients with gastrointestinal malignancies receiving 5-fluorouracil chemotherapy were randomly assigned into the control group and experimental group in Zhejiang Cancer Hospital. Each group had 23 cases. The control group received only chemotherapy, and the experimental group additionally received enteral nutrition support. The adverse reactions, nutritional status, immune function, intestinal barrier function, and dynamic changes in intestinal flora with successive chemotherapy courses were observed in the two groups.
      Results  1) Adverse reactions:the number of total adverse reactions such as nausea and vomiting was smaller in the experimental group than in the control group (P < 0.05). 2) Nutritional status:with successive chemotherapy courses, the prealbumin (PA) and transferrin (TF) showed an upward trend in the experimental group but a downward trend in the control group (P < 0.05). 3) T cell subsets:CD3+, CD4+, and CD4+/CD8+ showed an upward trend with successive chemotherapy courses, and it was significantly higher in the experimental group than in the control group (P < 0.05). 4) Immunoglobulin:IgG, IgA, and C4 were significantly higher in the experimental group than in the control group (P < 0.05). 5) Intestinal barrier function:from the fourth to sixth courses, the levels of D-lactic acid and diamine oxidase were significantly higher in the control group than in the experimental group (P < 0.05). 6) Intestinal flora:with successive chemotherapy courses, the Lactobacillus and Bifidobacteria were significantly lower (P < 0.05) and the Enterobacter and Enterococcus were significantly higher in the control group than in the experimental group (P < 0.05).
      Conclusions  Enteral nutrition can reduce the adverse reactions of chemotherapy, improve nutritional status and immune function of the body, reduce intestinal barrier function damage, and improve intestinal flora imbalance.

     

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