黄伯湘 朱玮 林冬群 林宇

【摘要】 目的  探究在老年肺癌患者圍术期应用加味金水六君煎的效果及对肺保护的作用。

方法  回顾性分析2020年1月至2021年1月接受治疗的老年肺癌围术期患者60例为研究对象，根据治疗方法不同将患者分为常规组与金水六君煎组，各30例。其中常规组在围手术期进行常规治疗，金水六君煎组在常规治疗上以加味金水六君煎治疗，分析两组患者中医证候积分，比较并分析肺、肾功能指标，以酶联免疫法检测血清血小板活化因子（PAF）、降钙素原（PCT）、细胞间黏附分子（ICAM-1）、表面活性蛋白A（SP-A）、丙二醛（MDA）、超氧化物歧化酶（SOD）水平。

结果  术后2周、4周金水六君煎组中医证候积分均低于常规组（ P <0.001）;干预后，金水六君煎组肾功能指标、ICAM-1、SP-A、MDA水平均较常规组低（ P <0.001），用力肺活量（FVC）、1 s用力呼气量（FEV1）及FEV1/FVC指标及SOD水平较常规组高（ P <0.05）;金水六君煎组并发症总发生率低于常规组，且敏感性高于常规组（ P <0.05）。

结论  在老年肺癌患者围术期结合加味金水六君煎进行干预，可减轻手术损伤，改善患者症状及肺功能，使手术造成的炎症情况及氧化状况较轻，抑制肺部功能出现的损伤，改善肺部细胞氧化程度。

【关键词】  肺癌;围术期;加味金水六君煎;肺保护;细胞间黏附分子

中图分类号： R734.2    文献标志码： A    DOI： 10.3969/j.issn.1003-1383.2021.08.004

Study on lung protection of modified Jinshui Liujun decoction in elderly  patients with lung cancer during the perioperative period

HUANG Boxiang， ZHU Wei， LIN Dongqun， LIN Yu

（The Second Department of Cardiovascular Medicine， University Town Hospital of Guangdong  Provincial Hospital of Chinese Medicine， Guangzhou 510180， Guangdong， China）

【Abstract】 Objective  To investigate the effect and lung protection of modified Jinshui Liujun decoction in elderly patients with lung cancer during perioperative period.

Methods  60 elderly perioperative patients with lung cancer treated from January 2020 to January 2021 were prospectively selected as research objects， and all patients were divided into routine group and Jinshu Liujun decoction group according to random number table method. The routine group were given routine treatment during the perioperative period， and based on which the Jinshui Liujun decoction group were given modified Jinshui Liujun decoction. And then， the TCM syndrome scores of the two groups were analyzed， and the indexes of lung and kidney function were compared and analyzed. The levels of serum platelet activating factor （PAF）， procalcitonin （PCT）， intercellular adhesion molecule （ICAM-1）， surfactant protein A （SP-A）， malondialdehyde （MDA） and superoxide dismutase （SOD） were detected by enzyme-linked immunosorbent assay.

Results  2 and 4 weeks after operation， the TCM syndrome scores in the Jinshui Liujun decoction group were lower than those in the routine group （ P  < 0.001）. After intervention， the renal function indexes， ICAM-1， SP-A and MDA levels in the Jinshui Liujun decoction group were lower than those in the routine group （ P  < 0.001）， and the FVC， FEV1， FEV1/FVC indexes and SOD levels were higher than those in the routine group （ P  < 0.05）; the total incidence of complications in the Jinshui Liujun decoction group was lower than that in the routine group， and the sensitivity was higher than that in the routine group （ P  < 0.05）.

Conclusion   Modified Jinshui Liujun decoction for elderly patients with lung cancer during perioperative period can reduce surgical injury， improve patients' symptoms and lung functions， alleviate the inflammation and oxidation caused by surgery， inhibit the damage of lung function and improve the oxidation degree of lung cells.

【Key words】  lung cancer; perioperative period; Jinshui Liujun decoction; lung protection; ICAM-1

肺癌在我国恶性肿瘤中已属于较为常见的疾病，多在老年人群中发生[1]。随着我国城市人口的老龄化，目前，如何降低老年肺癌患者开胸手术的病死率，提升围术期干预效果是临床医护人员所面临的一个困难的问题[2]。主要的治疗方法是采用手术切除肿瘤以有效控制肿瘤的生长[3]。做好围术期处理对提高患者的手术成功率、降低患者的病死率、减少并发症的发生等具有重要的意义[4]。……