Search JIM Advanced Search

Journal of Chinese Integrative Medicine ›› 2005, Vol. 3 ›› Issue (3): 195-198.doi: 10.3736/jcim20050309

• Original Clinical Research • Previous Articles     Next Articles

Effects of perioperative administration of rhubarb on acute inflammatory response in patients with gastric cancer

Jun Cai,Zheng-rong Xuan,Yong-ping Wei,Hai-bo Yang,Hua Wang   

  1. Department of General Surgery, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
  • Received:2005-03-18 Online:2005-05-20 Published:2005-05-20
  • Contact: Jun Cai


To observe the effect of perioperative administration of rhubarb on the acute inflammatory response in patients with gastric cancer.


In this prospective, single-blinded, controlled clinical trial, thirty-one patients with gastric cancer operatively treated were randomly divided into two groups, with 14 patients in control group and 17 in study group. Patients in both groups were given an isocaloric and isonitrogenous enteral diet. The enteral diet was started 36 hours after operation, and continued for 6 days. Patients in the study group were fed with rhubarb before operation, and at 1 day and 2 days after operation. Indexes of acute inflammatory response such as serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α), and indexes of nutritional status such as serum albumin (ALB), prealbumin (PA) and transferrin (TRF) were measured before operation, and at 1 day, 3 and 7 days after operation.


Patients in both groups had acute inflammatory response, and the indexes of nutritional status decreased after operation. IL-6, CRP and TNF-α tested at 3 and 7 days after operation were lower in the study group as compared with those in the control group, and the recovery time of gastrointestinal motility such as borborygmus, gas elimination and defecation was shorter in the study group as compared with that in the control group. The indexes of nutritional status showed no significant differences between two groups after operation.


Rhubarb can positively modulate the acute inflammatory response, promote the recovery of postoperative gastrointestinal motility, and benefit enteral nutrition support in patients who have undergone major operations for gastric cancer.

Key words: Stomach neoplasms, Rheum palmatum, Cytokines, Enteral nutrition

CLC Number: 

  • R735.2

Tab 1

Changes of indexes of inflammatory responses in two groups ($\bar{x}$±s)"

Group n CRP (mg/L) TNF-α (ng/L) IL-6 (ng/L)
Study group
Before operation 17 0.84± 0.23 40.50±18.46 12.58±4.31
1 day after operation 17 48.37±26.41 67.81±23.40 26.74±7.43
3 days after operation 17 12.63±7.81* 53.41±18.97* 20.08±5.85*
7 days after operation 17 5.14±2.37* 45.84±17.83* 15.82±6.44*
Control group
Before operation 14 0.73±0.35 39.86±17.34 13.27±5.44
1 day after operation 14 46.92±31.73 68.03±29.71 28.56±8.23
3 days after operation 14 29.62±19.03 66.23±15.94 26.84±10.67
7 days after operation 14 17.58±11.61 62.45±25.89 22.57±8.03

Tab 2

Changes of indexes of nutritional status in two groups ($\bar{x}$±s, g/L)"

Group n ALB PA TRF
Study group
Before operation 17 34.58±4.16 24.16±6.25 264.59±65.23
1 day after operation 17 30.33±3.47 17.98±4.57 178.47±52.88
3 days after operation 17 30.85±3.74 19.59±6.78 215.42±61.07
7 days after operation 17 32.75±3.89 24.05±7.18 281.61±62.56
Control group
Before operation 14 34.87±3.37 23.81±5.46 268.22±54.39
1 day after operation 14 31.05±4.60 18.54±5.79 191.50±48.88
3 days after operation 14 31.35±4.11 19.32±5.44 220.52±52.64
7 days after operation 14 32.81±3.97 22.70±6.95 252.09±56.13

Tab 3

Recovery time of gastrointestinal motility in two groups ($\bar{x}$±s, h)"

Group n Borborygmus Gas elimination Defecation
Study group 17 43.2±13.4* 52.6±12.7* 67.4±17.8*
Control group 14 56.5±16.8 80.6±18.2 87.4±21.5
[1] De Blaauw I , Deutz NEP, von Meyenfeldt MF.Metabolic changes in cancer cachexia--first of two parts[J]. Clin Nutr, 1997,16(4):169-176
doi: 10.1016/S0261-5614(97)80002-7 pmid: 16844595
[2] Tisdale MJ . Cancer cachexia: metabolic alterations and clinical manifestations[J]. Nutrition, 1997,13(1):1-7
doi: 10.1016/S0899-9007(96)00313-9 pmid: 9058439
[3] Yoshida S, Matsui M, Shirouzu Y , et al. Effects of glutamine supplements and radiochemotherapy on systemic immune and gut barrier function in patients with advanced esophageal cancer[J]. Ann Surg, 1998,227(4):485-491
doi: 10.1097/00000658-199804000-00006
[4] 吴国豪, 王浩, 张延伟 , 等. 消化道肿瘤手术后早期应用免疫增强型肠内营养的作用[J]. 肠外与肠内营养, 2003,10(1):8-11, 14
doi: 10.3969/j.issn.1007-810X.2003.01.003
[5] 彭淑梅, 王淑珍, 赵建平 . 大黄对全身炎症反应综合征患儿炎性因子和补体的影响及意义[J]. 中国中西医结合杂志, 2002,22(4):264-266
[6] 乔林, 陈德昌, 景炳文 , 等. 大黄对烫伤后大鼠肠粘膜上皮细胞线粒体功能的影响[J]. 中华急诊医学杂志, 2002,11(1):16-18
[7] 陈德昌, 景炳文, 杨兴易 , 等. 大黄对危重症患者胃肠道的保护作用[J]. 中国危重急救医学, 2000,12(2):87-90
[8] 李永渝, 魏玉, 李莉娟 , 等. 藿香、大黄等CCB中药影响胃肠道运动功能的机制探讨[J]. 中国中西医结合外科杂志, 1997,3(3):187-190
[1] Pádraic J.Dunne, Julie Lynch, Lucia Prihodova, Caoimhe O'Leary, Atiyeh Ghoreyshi, Sharee A. Basdeo, Donal J.Cox, Rachel Breen, Ali Sheikhi, Áine Carroll, Cathal Walsh, Geraldine McMahon, Barry White. Burnout in the emergency department: Randomized controlled trial of an attention-based training program. Journal of Integrative Medicine, 2019, 17(3): 173-180.
[2] J.M. Oliver-Baxter, H.S. Whitford, D.A. Turnbull, M.J. Bond. Effects of vitamin supplementation on inflammatory markers and psychological wellbeing among distressed women: A randomized controlled trial. Journal of Integrative Medicine, 2018, 16(5): 322-328.
[3] Uday P. Pratap, Hannah P. Priyanka, Karthik R. Ramanathan, Vishak Raman, Lalgi Hima, Srinivasan Thyagarajan. Noni (Morinda citrifolia L.) fruit juice delays immunosenescence in the lymphocytes in lymph nodes of old F344 rats. Journal of Integrative Medicine, 2018, 16(3): 199-207.
[4] Xuan Liu, Li-juan Xiu, Jian-peng Jiao, Jing Zhao, Ying Zhao, Ye Lu, Jun Shi, Yong-jin Li, Min Ye, Yu-fang Gu, Xiao-wei Wang, Jing-yu Xu, Ci-an Zhang, Yong-ying Liu, Yun Luo, Xiao-qiang Yue. Traditional Chinese medicine integrated with chemotherapy for stage IV non-surgical gastric cancer: A retrospective clinical analysis. Journal of Integrative Medicine, 2017, 15(6): 469-475.
[5] Lilian Uchoa Carneiro, Ilna Gomes da Silva, Mirian Eliza Alves de Souza, Wellington da Silva Côrtes, Mário Geraldo de Carvalho, Bruno Guimarães Marinho. Antinociceptive and anti-inflammatory activities of leaf extracts from Annona tomentosa R.E.Fr. Journal of Integrative Medicine, 2017, 15(5): 379-387.
[6] Shi-li Jiang, Xu-dong Hu, Ping Liu. Immunomodulation and liver protection of Yinchenhao decoction against concanavalin A-induced chronic liver injury in mice. Journal of Integrative Medicine, 2015, 13(4): 262-268.
[7] Ci-an Zhang, Feng Wu, Zhu-jun Mao, Zhen Wei, Yong-jin Li, Pin-kang Wei. Effects of ethanol extract of Rhizome Pinelliae Preparata on intracellular pH value of human gastric adenocarcinoma cells. Journal of Chinese Integrative Medicine, 2011, 9(8): 894-900.
[8] Jun Shi, Pin-kang Wei. The phlegm theory of gastric cancer. Journal of Chinese Integrative Medicine, 2011, 9(6): 581-587.
[9] Jun Shi, Pin-kang Wei. Eight therapies of resolving phlegm and dispersing nodules in treatment of gastric cancer: Experience from Professor Wei Pin-kang. Journal of Chinese Integrative Medicine, 2011, 9(10): 1066-1069.
[10] Wen Sun, Jian Yu, Yu-min Shi, Hao Zhang, Ying Wang, Bing-bing Wu. Effects of Cordyceps extract on cytokines and transcription factors in peripheral blood mononuclear cells of asthmatic children during remission stage. Journal of Chinese Integrative Medicine, 2010, 8(4): 341-346.
[11] Daniel Weber, Janelle M Wheat, Geoffrey M Currie. Inflammation and cancer: Tumor initiation, progression and metastasis,and Chinese botanical medicines. Journal of Chinese Integrative Medicine, 2010, 8(11): 1006-1013.
[12] NN Liu, N Zhou, Y Wang, X Liu, LH Zhou, Q Wu, J Sun, ZZ Fan, Q Li. Chinese herbal medicine Jianpi Jiedu Formula down-regulates the expression of vascular endothelial growth factor in human gastric cell line MKN45 induced by Helicobacter pylori by inhibiting cyclooxygenase-2. Journal of Chinese Integrative Medicine, 2010, 8(10): 968-973.
[13] Zhi-ping Dong , Zhi-qian Hu, Wei Peng, Zhi-jun Shu, Ye-min Cao, Lei Lu. Effects of Baihe Recipe on expressions of vascular endothelial growth factor and p53 proteins in tumor tissues of nude mice bearing orthotopically transplanted gastric carcinoma BGC-823. Journal of Chinese Integrative Medicine, 2009, 7(5): 458-462.
[14] Wei Zhang, Jing-tao Cao, Hai-yu Liu. Effects of pathogenic wind-dampness on lung tissue cytokines in rats with syndrome due to pathogenic cold invading lung. Journal of Chinese Integrative Medicine, 2008, 6(7): 748-751.
[15] Sheng-li Tian, Yong-ming Zhou, Tao Huang, Zhi-zhong Xue, Wei He. Effects of Yisui Jiedu Recipe on JAK2-STAT5 signal transduction pathway in bone marrow hematopoietic cells from patients with myelodysplastic syndrome-refractory anemia. Journal of Chinese Integrative Medicine, 2008, 6(2): 185-189.
Full text



[1] Jun Hu, Jian-ping Liu. Non-invasive physical treatments for chronic/recurrent headache. Journal of Chinese Integrative Medicine, 2008, 6(1): 31
[2] Zhi-chun Jin. Problems in establishing clinical guideline for integrated traditional Chinese and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 5-8
[3] Ya-bing Zhou, Jian-er Yu, Jie Wu, Li Bai, Li-li Huo, Xin-guang Zhang, Li-qing Li . Effects of Chinese herbal medicine Bushen Gubiao Recipe on toll-like receptor 4 and CD4 +CD25 +foxp3 +regulatory T cells in mice with recurrent respiratory tract infections. Journal of Chinese Integrative Medicine, 2010, 8(11): 1053-1059
[4] Nian-hong Wang , Jun-tao Yan , Wu-quan Sun , Yong-shan Hu , Jun Xia , Li-cheng Wei , Jie Jia , Gui-lin Ouyang , Yong He , Yan-ming Guo , Jie Xu . Effects of early application of Tuina treatment on quadriceps surface myoelectricity in patients after total knee arthroplasty: a randomized controlled trial. Journal of Chinese Integrative Medicine, 2012, 10(11): 1247-1253
[5] Ying Xu , Chang-chun Zeng , Xiu-yu Cai , Rong-ping Guo , Guang Nie , Ying Jin. Chromaticity and optical spectrum colorimetry of the tongue color in different syndromes of primary hepatic carcinoma. Journal of Chinese Integrative Medicine, 2012, 10(11): 1263-1271
[6] Zhao-guo Li. Studies on English translation of the titles of traditional Chinese medicine specialties. Journal of Chinese Integrative Medicine, 2010, 8(12): 1199-1206
[7] Mei-jun Lü, Hui-yong Zhang, Zhe Zhang, Guan-lin Yang. Measurement of health-related quality of life in coronary heart disease: A review. Journal of Chinese Integrative Medicine, 2011, 9(12): 1277-1285
[8] Shuo Zhang , Hong-cai Shang. Correlation between traditional Chinese medicine syndromes and omics: A literature review. Journal of Chinese Integrative Medicine, 2011, 9(12): 1286-1291
[9] Qin-hui Fu, Jian Pei, Jian-rong Hui, Yi Song . Studies on dynamic changes in traditional Chinese medicine syndrome patterns for stroke using data-driven and model-driven approaches: A review. Journal of Chinese Integrative Medicine, 2011, 9(12): 1292-1300
[10] Jia Guo, Li-na Wang, Dong Li. Exploring the effects of Chinese medicine in improving uterine endometrial blood flow for increasing the successful rate of in vitro fertilization and embryo transfer. Journal of Chinese Integrative Medicine, 2011, 9(12): 1301-1306