艾灸联合免疫肠内营养对新辅助化疗胃癌患者营养状况、免疫功能及热休克蛋白70的影响

目的观察艾灸联合免疫肠内营养(IEN)对新辅助化疗胃癌患者营养状况、免疫功能及血清热休克蛋白70(HSP70)的影响。方法选取接受3个周期新辅助化疗并行胃癌根治术的88例进展期胃癌患者,随机分为对照组和观察组,每组44例。对照组于每次化疗当天开始予IEN支持,连续7 d,观察组在对照组基础上联合艾灸治疗。比较两组患者化疗前、化疗后及术后第7天的营养指标包括体质量、转铁蛋白(TRF)、前清蛋白(PA)、白蛋白(ALB)]、体液免疫指标(IgA、IgM、IgG)、细胞免疫指标(CD3﹢、CD4﹢、CD4﹢/CD8﹢)以及血清HSP70的变化。结果化疗后及术后第7天,两组患者体质量、TRF、PA、ALB、体液免疫和细胞免疫指标下降(P<0.05),血清HSP70水平均升高(P<0.05);观察组体质量、TRF、PA、ALB、细胞免疫指标高于对照组(P<0.05),两组体液免疫指标比较,差异无统计学意义(P>0.05)。结论艾灸联合IEN可改善患者营养状况,提高免疫细胞水平,达到保护机体免疫功能的作用。

Effects of Moxibustion Combined with Immune Enteral Nutrition on the Nutritional Status,Immune Function and HSP70 in Gastric Cancer Patients Undergoing Neoadjuvant Chemotherapy

Objective To observe the effects of moxibustion plus immune enteral nutrition(IEN)on the nutritional status,immune function and serum heat shock protein 70(HSP70)in gastric cancer patients undergoing neoadjuvant chemotherapy.Method Eighty-eight patients with gastric cancer in progressive stage undergoing 3 cycles of neoadjuvant chemotherapy and radical gastrectomy were randomized into a control group and an observation group,with 44 cases in each group.The control group started to receive IEN support on the same day of chemotherapy for 7 consecutive days,based on which the observation group was given moxibustion treatment.Before and after chemotherapy and on postoperative day 7,changes in the nutritional indicatorsincluding body weight,transferrin(TRF),prealbumin(PA)and albumin(ALB),humoral immune indicators immunoglobulin(Ig)A,IgM and IgG],cellular immunity(CD3﹢,CD4﹢and CD4﹢/CD8﹢)and serum HSP70 were compared between the two groups.Result After chemotherapy and on postoperative day 7,the body weight,TRF,PA,ALB,humoral immune and cellular immune indicators decreased(P<0.05)and the serum HSP70 level increased(P<0.05)in both groups;the body weight,TRF,PA,ALB and cellular immune indicators were higher in the observation group than in the control group(P<0.05),while there were no significant differences comparing the humoral immune indicators between the two groups(P>0.05).Conclusion Moxibustion plus IEN can improve the nutritional status and increase the immune cell levels to protect the immune function of the patients.