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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 E-mail:caijun509@yahoo.com.cn

Objective

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

Methods

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.

Results

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.

Conclusion

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
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